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CHICAGO — Increases in the availability of magnetic resonance imaging are significantly associated with increases in utilization of lower back MRI and lower back pain surgery, a study of 832,000 episodes of treatment among Medicare recipients has shown.
Patients in geographic areas with the highest quartile of MRI availability were 15% more likely to receive lower back MRI within 30 days of an initial doctor visit and 10% more likely to receive lower back MRI within a year, compared with patients living in areas with the lowest quartile of MRI availability, according to Jacqueline Baras Shreibati, a medical student at Stanford (Calif.) University, and Laurence C. Baker, Ph.D., professor of health research and policy at Stanford. These patients also were significantly more likely to undergo surgery for their ailments, they reported at the annual research meeting of AcademyHealth.
“These results raise concerns that the widespread expansion of MRI may adversely impact quality of care for low back pain patients,” they stated. “The rapid expansion in the number of MRI scanners in the United States has enabled more patients to receive cutting-edge imaging that can produce valuable diagnostic information. However, for patients with low back pain, the use of MRI is controversial. Spinal abnormalities detected by MRI often do not correlate with symptoms and can lead to unnecessary interventions, including surgery, which in many patients is of uncertain efficacy.”
The researchers used claims from a 20% sample of Medicare beneficiaries from 1998-2005. Cohorts were developed of patients with a new episode of care for low back pain in 1999, 2002, and 2005, years for which data were available on the number of MRI units per million people in U.S. metropolitan statistical areas. Patients were assigned to an MRI quartile based on their metropolitan statistical area of residence. The researchers examined the impact of MRI availability on the receipt of low back pain MRI and surgery within 30, 90, 180, or 365 days of the initial visit.
Among all low back pain episodes of care, 18% resulted in MRI and 4% resulted in low back pain surgery within a year of the initial visit. The authors reported no conflicts of interest.
CHICAGO — Increases in the availability of magnetic resonance imaging are significantly associated with increases in utilization of lower back MRI and lower back pain surgery, a study of 832,000 episodes of treatment among Medicare recipients has shown.
Patients in geographic areas with the highest quartile of MRI availability were 15% more likely to receive lower back MRI within 30 days of an initial doctor visit and 10% more likely to receive lower back MRI within a year, compared with patients living in areas with the lowest quartile of MRI availability, according to Jacqueline Baras Shreibati, a medical student at Stanford (Calif.) University, and Laurence C. Baker, Ph.D., professor of health research and policy at Stanford. These patients also were significantly more likely to undergo surgery for their ailments, they reported at the annual research meeting of AcademyHealth.
“These results raise concerns that the widespread expansion of MRI may adversely impact quality of care for low back pain patients,” they stated. “The rapid expansion in the number of MRI scanners in the United States has enabled more patients to receive cutting-edge imaging that can produce valuable diagnostic information. However, for patients with low back pain, the use of MRI is controversial. Spinal abnormalities detected by MRI often do not correlate with symptoms and can lead to unnecessary interventions, including surgery, which in many patients is of uncertain efficacy.”
The researchers used claims from a 20% sample of Medicare beneficiaries from 1998-2005. Cohorts were developed of patients with a new episode of care for low back pain in 1999, 2002, and 2005, years for which data were available on the number of MRI units per million people in U.S. metropolitan statistical areas. Patients were assigned to an MRI quartile based on their metropolitan statistical area of residence. The researchers examined the impact of MRI availability on the receipt of low back pain MRI and surgery within 30, 90, 180, or 365 days of the initial visit.
Among all low back pain episodes of care, 18% resulted in MRI and 4% resulted in low back pain surgery within a year of the initial visit. The authors reported no conflicts of interest.
CHICAGO — Increases in the availability of magnetic resonance imaging are significantly associated with increases in utilization of lower back MRI and lower back pain surgery, a study of 832,000 episodes of treatment among Medicare recipients has shown.
Patients in geographic areas with the highest quartile of MRI availability were 15% more likely to receive lower back MRI within 30 days of an initial doctor visit and 10% more likely to receive lower back MRI within a year, compared with patients living in areas with the lowest quartile of MRI availability, according to Jacqueline Baras Shreibati, a medical student at Stanford (Calif.) University, and Laurence C. Baker, Ph.D., professor of health research and policy at Stanford. These patients also were significantly more likely to undergo surgery for their ailments, they reported at the annual research meeting of AcademyHealth.
“These results raise concerns that the widespread expansion of MRI may adversely impact quality of care for low back pain patients,” they stated. “The rapid expansion in the number of MRI scanners in the United States has enabled more patients to receive cutting-edge imaging that can produce valuable diagnostic information. However, for patients with low back pain, the use of MRI is controversial. Spinal abnormalities detected by MRI often do not correlate with symptoms and can lead to unnecessary interventions, including surgery, which in many patients is of uncertain efficacy.”
The researchers used claims from a 20% sample of Medicare beneficiaries from 1998-2005. Cohorts were developed of patients with a new episode of care for low back pain in 1999, 2002, and 2005, years for which data were available on the number of MRI units per million people in U.S. metropolitan statistical areas. Patients were assigned to an MRI quartile based on their metropolitan statistical area of residence. The researchers examined the impact of MRI availability on the receipt of low back pain MRI and surgery within 30, 90, 180, or 365 days of the initial visit.
Among all low back pain episodes of care, 18% resulted in MRI and 4% resulted in low back pain surgery within a year of the initial visit. The authors reported no conflicts of interest.