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Public Reporting of MRI of the Lumbar Spine for Low Back Pain and Changes in Clinical Documentation
- Source :
- Journal of the American College of Radiology. 14:1545-1551
- Publication Year :
- 2017
- Publisher :
- Elsevier BV, 2017.
-
Abstract
- OP-8 is the Medicare imaging efficiency metric for MRI of the lumbar spine for low back pain in the outpatient hospital. We studied trends in exclusion criteria coding over time by site of service after implementation of OP-8 to evaluate provider's response to public reporting.We conducted a secondary data analysis using the Medicare Limited Data Set 5% sample for beneficiaries with MRI lumbar spine and lower back pain during 2009 to 2014. We evaluated the association between excluding condition prevalence and site by using generalized estimating equations regression. We produced model-based estimates of excluding condition prevalence by site and year. As a sensitivity analysis, we repeated the analysis while including additional conditions in the outcome measure.We included 285,911 MRIs of the lumbar spine for low back pain. Generalized estimating equations regression found that outpatient hospitals had a higher proportion of MRIs with at least one excluding condition documented compared with outpatient clinics (P.05), but increases in excluding condition prevalence were similar across all sites during 2009 to 2014. Our results were not sensitive to the inclusion of additional conditions.Documentation of excluding conditions and other clinically reasonable exclusions for OP-8 increased over time for outpatient hospitals and clinics. Increases in documentation of comorbidities may not translate to actual improvement in imaging appropriateness for low back pain. When accounting for all relevant conditions, the proportion of patients with low back pain considered uncomplicated and being measured by OP-8 would be small, reflecting a small proportion of patients with low back pain.
- Subjects :
- Male
medicine.medical_specialty
Datasets as Topic
Documentation
Medicare
030218 nuclear medicine & medical imaging
03 medical and health sciences
0302 clinical medicine
Public reporting
Ambulatory Care
Prevalence
medicine
Back pain
Humans
Outpatient clinic
Radiology, Nuclear Medicine and imaging
Generalized estimating equation
Lumbar Vertebrae
business.industry
Secondary data
Magnetic Resonance Imaging
Low back pain
United States
030220 oncology & carcinogenesis
Physical therapy
Female
Lumbar spine
medicine.symptom
business
Low Back Pain
Subjects
Details
- ISSN :
- 15461440
- Volume :
- 14
- Database :
- OpenAIRE
- Journal :
- Journal of the American College of Radiology
- Accession number :
- edsair.doi.dedup.....96a87de4c32e91abfde2c305908b350f