Magnetic resonance imaging and low back pain care for medicare patients: More MRI scanners appear to translate into more scans and more surgeries for enrollees

Health Affairs

Volumn 28, Issue 6, 2009, Pages w1133-w1140

  Baras, Jacqueline D ^a   Baker, Laurence C ^b  

^a STANFORD UNIVERSITY   (United States)

^b Health Research and Policy   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

ARTICLE; HEALTH CARE UTILIZATION; LOW BACK PAIN; MEDICARE; NUCLEAR MAGNETIC RESONANCE IMAGING; PATIENT CARE; PROBABILITY; SPINE SURGERY; COMPARATIVE STUDY; COST; FEMALE; HUMAN; MALE; MEDICAL FEE; STATISTICAL MODEL; SURGERY; UNITED STATES; UTILIZATION REVIEW;

COSTS AND COST ANALYSIS; FEE-FOR-SERVICE PLANS; FEMALE; HUMANS; LOGISTIC MODELS; LOW BACK PAIN; MAGNETIC RESONANCE IMAGING; MALE; MEDICARE; SURGICAL PROCEDURES, OPERATIVE; UNITED STATES;

EID: 77957805046     PISSN: 02782715     EISSN: 15445208     Source Type: Journal    
DOI: 10.1377/hlthaff.28.6.w1133     Document Type: Article

References (26)

1. Organization for Economic Cooperation and Development. OECD health data 2001: A comparative analysis of twenty-nine countries. Paris (France): OECD; 2001.
2. Organization for Economic Cooperation and Development. OECD health data 2005: A comparative analysis of twenty-nine countries. Paris (France): OECD; 2005.
3. Baker LC, Atlas SW, Afendulis CC. Expanded use of imaging technology and the challenge of measuring value. Health Aff (Millwood). 2008;27 (6):1467–78.
4. U.S. Government Accountability Office. Medicare Part B imaging services: Rapid spending growth and shift to physician offices indicate need for CMS to consider additional management practices. Washington (DC): GAO; 2008. Report no. GAO-08-452.
5. Hart LG, Deyo RA, Cherkin DC. Physician office visits for low back pain. Frequency, clinical evaluation, and treatment patterns from a U.S. national survey. Spine. 1995;20(1):11–9.
6. Weiner DK, Kim YS, Bonino P, Wang T. Low back pain in older adults: Are we utilizing healthcare resources wisely? Pain Med. 2006;7(2):143–50.
7. Jarvik JG, Deyo RA. Diagnostic evaluation of low back pain with emphasis on imaging. Ann Intern Med. 2002;137(7):586–97.
8. Boden SD, Mc Cowin PR, Davis DO, Dina TS, Mark AS, Wiesel S. Abnormal magnetic-resonance scans of the cervical spine in asymptomatic subjects: A prospective investigation. J Bone Joint Surg Am. 1990;72(8):1178–84.
9. Jensen MC, Brant-Zawadzki MN, Obuchowski N, Modic MT, Malkasian D, Ross JS. Magnetic resonance imaging of the lumbar spine in people without back pain. N Engl J Med. 1994;331(2): 69–73.
10. Deyo RA. Magnetic resonance imaging of the lumbar spine: Terrific test or tar baby? N Engl J Med. 1994;331(2):115–6.
11. Deyo RA. Back surgery—who needs it? N Engl J Med. 2007;356(22):2239–43.
12. Deyo RA. Diagnostic evaluation of LBP: Reaching a specific diagnosis is often impossible. Arch Intern Med. 2002;162(13):1444–7.
13. Gibson JN, Waddell G. Surgery for degenerative lumbar spondylosis. Cochrane Database Syst Rev. 2005(4):CD001352.
14. Further information about cohort selection, the regression analysis, and patient demographic and clinical characteristics can be found in the online appendix at http://content.healthaffairs.org/cgi/content/full/healthaff.28.6.w1133/DC2.
15. Baker LC, Atlas SW. Relationship between HMO market share and the diffusion and use of advanced MRI technologies. J Am Coll Radiol. 2004;1(7):478–87.
16. Elixhauser A, Steiner C, Harris DR, Coffey RM. Comorbidity measures for use with administrative data.Med Care. 1998;36(1):8–27.
17. Baker L, Birnbaum H, Geppert J, Mishol D, Moyneur E. The relationship between technology availability and health care spending. Health Aff (Millwood). 2003;22:w3-537–51.
18. Fuchs VR. The supply of surgeons and the demand for operations. J Hum Resour. 1978;13 Suppl:35–56.
19. Lurie JD, Birkmeyer NJ, Weinstein JN. Rates of advanced spinal imaging and spine surgery. Spine. 2003;28(6):616–20.
20. Cutler DM, Mc Clellan M. Is technological change in medicine worth it? Health Aff (Millwood). 2001;20(5):11–29.
21. Fisher ES, Wennberg DE, Stukel TA, Gottlieb DJ, Lucas FL, Pinder EL. The implications of regional variations in Medicare spending. Part 1: The content, quality, and accessibility of care. Ann Intern Med. 2003;138(4):273–87.
22. Fisher ES, Wennberg DE, Stukel TA, Gottlieb DJ, Lucas FL, Pinder EL. The implications of regional variations in Medicare spending. Part 2: Health outcomes and satisfaction with care. Ann Intern Med. 2003;138(4):288–98.
23. Bigos S, Bowyer O, Braen G. Acute low back problems in adults: Clinical practice guideline no.14. Rockville (MD): Agency for Healthcare Policy and Research; 1994 Dec. Pub. no. 95-0642.
24. Chou R, Qaseem A, Snow V, Casey D, Cross JT, Jr., Shekelle P, et al. Diagnosis and treatment of low back pain: A joint clinical practice guideline from the American College of Physicians and the American Pain Society. Ann Intern Med. 2007; 147(7):478–91.
25. Chou R, Fu R, Carrino JA, Deyo RA. Imaging strategies for low-back pain: Systematic review and meta-analysis. Lancet. 2009;373(9662):463–72.
26. Weinstein JN, Lurie JD, Tosteson TD, Hanscom B, Tosteson AN, Blood EA, et al. Surgical versus nonsurgical treatment for lumbar degenerative spondylolisthesis. N Engl J Med. 2007;356(22): 2257–70.