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2015 ; 5
(12
): e009011
Nephropedia Template TP
gab.com Text
Twit Text FOAVip
Twit Text #
English Wikipedia
Trends in hospital admissions and surgical procedures for degenerative lumbar
spine disease in England: a 15-year time-series study
#MMPMID26671956
Sivasubramaniam V
; Patel HC
; Ozdemir BA
; Papadopoulos MC
BMJ Open
2015[Dec]; 5
(12
): e009011
PMID26671956
show ga
OBJECTIVES: Low back pain (LBP), from degenerative lumbar spine disease,
represents a significant burden on healthcare resources. Studies worldwide report
trends attributable to their country's specific demographics and healthcare
system. Considering England's specific medico-socioeconomic conditions, we
investigate recent trends in hospital admissions and procedures for LBP, and
discuss the implications for the allocation of healthcare resources. DESIGN:
Retrospective cohort study using Hospital Episode Statistics data relating to
degenerative lumbar spine disease in England, between 1999 and 2013. Regression
models were used to analyse trends. OUTCOME MEASURES: Trends in the number of
admissions and procedures for LBP, mean patient age, gender and length of stay.
RESULTS: Hospital admissions and procedures have increased significantly over the
study period, from 127.09 to 216.16 and from 24.5 to 48.83 per 100,000,
respectively, (p<0.001). The increase was most marked in the oldest age groups
with a 1.9 and 2.33-fold increase in admissions for patients aged 60-74 and ? 75
years, respectively, and a 2.8-fold increase in procedures for those aged ? 60
years. Trends in hospital admissions were characterised by a widening gender gap,
increasing mean patient age, and decreasing mean hospital stay (p<0.001). Trends
in procedures were characterised by a narrowing gender gap, increasing mean
patient age (p=0.014) and decreasing mean hospital stay (p<0.001). Linear
regression models estimate that each hospital admission translates to 0.27
procedures, per 100,000 (95% CI 0.25 to 0.30, r 0.99, p<0.001; r, Pearson's
correlation coefficient). Hospital admissions are increasing at 3.5 times the
rate of surgical procedures (regression gradient 7.63 vs 2.18 per 100,000/year).
CONCLUSIONS: LBP represents a significant and increasing workload for hospitals
in England. These trends demonstrate an increasing demand for specialists
involved in the surgical and non-surgical management of this disease, and
highlight the need for services capable of dealing with the increased comorbidity
burden associated with an ageing patient group.
|Adolescent
[MESH]
|Adult
[MESH]
|Aged
[MESH]
|Comorbidity
[MESH]
|Cost of Illness
[MESH]
|England
[MESH]
|Female
[MESH]
|Forecasting
[MESH]
|Hospitalization/*trends
[MESH]
|Hospitals
[MESH]
|Humans
[MESH]
|Length of Stay/*statistics & numerical data
[MESH]