scholarly journals P.217 Patient reported outcomes following surgery for lumbar spinal stenosis: Comparison of a universal and multitier health care system

2021 ◽  
Vol 48 (s3) ◽  
pp. S82-S82
Author(s):  
O Ayling ◽  
C FIsher
Keyword(s):  
United States ◽  
Health Care ◽  
Spinal Stenosis ◽  
Health Care System ◽  
Lumbar Spinal Stenosis ◽  
Outcome Research ◽  
Patient Reported Outcomes ◽  
The United States ◽  
Patient Reported ◽  
Lumbar Spinal

Background: Canada has a universal health care system while the United States utilizes a combined public and private payer system. The purpose of this study is to investigate whether there are differences in clinical outcomes between those surgically treated for spinal stenosis in Canada as compared to the United States. Methods: Surgical lumbar spinal stenosis patients treated in Canada that were enrolled in the Canadian Spine Outcome Research Network (CSORN) prospective multicenter registry were compared with the surgical cohort enrolled in the Spine Patients Outcome Research Trial (SPORT) study. Spine-related patient reported outcomes (PROs) were compared at 3 months and 1 year post-operatively. Results: The CSORN cohort consisted of 432 patients and the SPORT cohort was made up of 278 patients. The CSORN cohort had a higher proportion of patients with a symptom duration greater than 6 months (92.3% vs. 58.3%, p<0.0001). The CSORN cohort demonstrated significantly greater rates of satisfaction after surgery at 3 months (p=0.003) and 1 year (p<0.001). Conclusions: Patients undergoing surgical treatment for lumbar spinal stenosis in Canada (CSORN cohort) reported higher rates of satisfaction at 3 months and 1 year post-operatively compared to the United States cohort (SPORT) despite having longer durations of symptoms prior to surgery.

scholarly journals Patient Reported Outcomes Following Surgery for Lumbar Disc Herniation: Comparison of a Universal and Multitier Health Care System

Neurosurgery ◽  
2019 ◽  
Vol 66 (Supplement_1) ◽  
Author(s):  
Oliver G S Ayling ◽  
Tamir T Ailon ◽  
Nicolas Dea ◽  
Charles Fisher
Keyword(s):  
United States ◽  
Health Care ◽  
Health Care System ◽  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Outcome Research ◽  
Patient Reported Outcomes ◽  
Lumbar Disc ◽  
The United States ◽  
Patient Reported

Abstract INTRODUCTION Canada has a universal health care system that is government funded and access to specialist care requires a referral by general practitioners. The United States utilizes a blended public and private payer system where insured patients can directly access specialists. The purpose of this study is to investigate whether there are differences in outcomes in the two systems. METHODS Surgical lumbar disc herniation patients treated between 2013 and 2016 in Canada that were enrolled in the Canadian Spine Outcome Research Network (CSORN) prospective multicenter registry. The Canadian cohort was compared with the surgical cohort enrolled in the Spine Patients Outcome Research Trial (SPORT) study. Baseline demographics and spine-related patient reported outcomes (PROs) were compared at 3 mo and 1 yr postoperatively. RESULTS The CSORN cohort consisted of 703 patients and the SPORT cohort was made up of 573 patients. The rate of females in each cohort was similar (47.2% vs 46.4%, P = .78), however, patients in the CSORN cohort were older (46.2 13.2 vs 41.6 10.9, P < .001), had a higher rate of smoking (32.0% vs 22.8%, P < .001), and were more likely to be employed (66.9% vs 61.3%, P = .034). The CSORN cohort had a slightly lower Owestry Disability score at baseline (50.515.1 vs 55.7 19.6, P < .01) but had a higher proportion of patients with a symptom duration greater than 6 mo (44.5% vs 21.1%, P < .0001). The CSORN cohort demonstrated significantly greater rates of satisfaction after surgery at 3 mo (74.8% vs 65.3%, P = .003) and 1 yr (81.4% vs 68.7%, P < .001). Improvements in back and leg pain followed similar trajectories. CONCLUSION Patients undergoing surgical treatment for lumbar disc herniation in Canada (CSORN cohort) reported higher rates of satisfaction at 3 mo and 1 yr postoperatively compared to the United States cohort (SPORT) despite having longer durations of symptoms prior to surgery.

scholarly journals P.218 Patient reported outcomes following surgery for lumbar disk herniation: comparison of a universal and multitier health care system.

2021 ◽  
Vol 48 (s3) ◽  
pp. S82-S83
Author(s):  
O Ayling ◽  
C FIsher
Keyword(s):  
United States ◽  
Health Care ◽  
Health Care System ◽  
Outcome Research ◽  
Patient Reported Outcomes ◽  
The United States ◽  
Disk Herniation ◽  
Lumbar Disk Herniation ◽  
Lumbar Disk ◽  
Patient Reported

Background: Canada has a universal health care system that is funded by the government while the United States utilizes a combined public and private payer system. The purpose of this study is to investigate whether there are differences in clinical outcomes between those surgically treated for lumbar disk herniation in Canada as compared to the United States. Methods: Surgical lumbar disk herniation patients enrolled in the Canadian Spine Outcome Research Network (CSORN) prospective registry. were compared with the surgical cohort enrolled in the Spine Patients Outcome Research Trial (SPORT) study. Spine-related patient reported outcomes (PROs) were compared at 3 months and 1 year. Results: The CSORN cohort consisted of 443 patients and the SPORT cohort was made up of 573 patients. Patients in the CSORN cohort were older (p<0.001), and were more likely to be employed (p=0.003). The CSORN cohort demonstrated significantly greater rates of satisfaction after surgery at 3 months (87.2% vs. 65.5%, p=0.003) and 1 year (85.6% vs. 69.0%, p<0.0001). The CSORN cohort was a significant independent predictor of patient satisfaction at 1 year. Conclusions: Patients undergoing surgical treatment for lumbar disc herniation in Canada reported higher rates of satisfaction at 3 months and 1 year post-operatively compared to the United States.

scholarly journals Wide Variability in Patient-Reported Outcomes Measures After Fusion for Lumbar Spinal Stenosis: A Systematic Review

2019 ◽  
Vol 10 (2) ◽  
pp. 209-215 ◽  
Author(s):  
James P. Winebrake ◽  
Francis Lovecchio ◽  
Michael Steinhaus ◽  
James Farmer ◽  
Andrew Sama
Keyword(s):  
Systematic Review ◽  
Return To Work ◽  
Spinal Stenosis ◽  
Lumbar Spinal Stenosis ◽  
Patient Reported Outcomes ◽  
Interbody Fusion ◽  
Inclusion Criteria ◽  
Pertinent Data ◽  
Patient Reported ◽  
Lumbar Spinal

Study Design: Systematic review. Objectives: The purpose of this study is to review outcomes reporting methodology in studies evaluating fusion for lumbar spinal stenosis. Methods: A systematic review of PubMed and Embase databases was conducted from January 2007 to June 2017 for English language studies with minimum of 2 years postoperative follow-up reporting outcomes after fusion for lumbar spinal stenosis. Two reviewers assessed each study; those meeting inclusion criteria were examined for pertinent data. Outcome measures were categorized into relevant domains: pain/symptomatology, function/disability, and surgical satisfaction. Return to work reporting was also recorded. Results: Of 123 studies meeting inclusion criteria, 76% included posterior-only fusion, 32% included posterior/transforaminal interbody fusion, and 5% included anterior/lateral interbody fusion (non-mutually exclusive). There was significant variation in patient-reported outcomes (PROs) used—studies reported 31 unique PROs assessing at least one domain: 22 evaluating pain, 23 evaluating function, and 3 evaluating surgical satisfaction. Most commonly utilized PROs were the Oswestry Disability Index (73% of studies), Visual Analog Scale (55%), and 36-Item Short Form Survey (32%). The remaining 28 measures were used in 14% of studies or fewer. PROs specific to symptoms of lumbar spinal stenosis, such as the Zurich Claudication Questionnaire, were only used rarely (7/123 studies). Only 14% of studies reported on time to return to work. Conclusions: The literature surrounding fusion in the setting of lumbar stenosis is characterized by substantial variability in outcomes reporting. Very few studies utilized measures specific to lumbar spinal stenosis. Efforts to standardize outcomes reporting would facilitate comparisons of surgical interventions.

Functional and Patient-Reported Outcomes in Symptomatic Lumbar Spinal Stenosis Following Percutaneous Decompression

Pain Practice ◽  
2012 ◽  
Vol 12 (6) ◽  
pp. 417-425 ◽  
Author(s):  
Nagy Mekhail ◽  
Shrif Costandi ◽  
Benjamin Abraham ◽  
Samuel Wadie Samuel
Keyword(s):  
Spinal Stenosis ◽  
Lumbar Spinal Stenosis ◽  
Patient Reported Outcomes ◽  
Patient Reported ◽  
Lumbar Spinal

scholarly journals Unilateral Tubular Approach for Bilateral Laminotomy vs Transforaminal Lumbar Interbody Fusion for Lumbar Spinal Stenosis

2020 ◽  
Author(s):  
Bin Lv ◽  
Minjie Hu ◽  
Lei Zhang ◽  
Shiqi Bi
Keyword(s):  
Spinal Stenosis ◽  
Lumbar Spinal Stenosis ◽  
Patient Reported Outcomes ◽  
Transforaminal Lumbar Interbody Fusion ◽  
Contralateral Side ◽  
Invasive Technique ◽  
Endoscopic Techniques ◽  
Patient Reported ◽  
Tissue Sparing ◽  
Lumbar Spinal

Abstract Background: Endoscopic techniques is considered to be the standard tissue sparing approach for surgical advantages, rapid rehabilitation, and instability prevention. PEID techniques were introduced to treat lumbar spinal stenosis. However, its effectiveness and safety in the treatment of moderate and severe lumbar stenosis is uncertain.Methods: Between June 2014 and June 2016, patients suffering from lumbar spinal stenosis underwent a bilateral laminotomy through a unilateral tubular approach. Demographics, intraoperative data, and patient-reported outcomes were ascertainedResults:There were no significant differences in patient demographics between the two groups. The statistically significant improvements in leg and back VAS scores were reported on the ipsilateral and the contralateral side (p<0.05, respectively). Analysis of VAS and ODI scores demonstrated no significant differences in improvement on both groups. There were no difference in radiographical and intraoperative outcomes during the follow-up period. Conclusions: Regarding the intraoperative data, and patient-reported outcomes, the PEID is a safety, and efficacy minimally invasive technique. This observation suggests that the PEID techniques were excellent or showed good results.

Should Screening Programs Be Perfect?

PEDIATRICS ◽  
1983 ◽  
Vol 71 (2) ◽  
pp. 301-301
Author(s):  
PHILIP R. WYATT
Keyword(s):  
United States ◽  
Health Care ◽  
Early Detection ◽  
New England ◽  
Health Care System ◽  
The United States ◽  
Neonatal Hypothyroidism ◽  
Screening Programs ◽  
Care System

To the Editor.— The report of the New England Regional Screening Program1 on neonatal hypothyroidism is a stunning illustration of the vulnerability of screening programs. It is unfortunate that this experience will probably be used as an argument to minimize the input of screening programs in the health care system in the United States. The report illustrates that, in addition to the 2% of the screened population that eluded the program, 14 infants with hypothyroidism escaped the full benefits of early detection and treatment.

scholarly journals An Opportunity for Pharmacists to Help Improve Coordination and Continuity of Patient Health Care

Pharmacy ◽  
2018 ◽  
Vol 6 (3) ◽  
pp. 78 ◽  
Author(s):  
Jon Schommer ◽  
Lawrence Brown ◽  
Ryan Bortz ◽  
Alina Cernasev ◽  
Basma Gomaa ◽  
...  
Keyword(s):  
United States ◽  
Health Care ◽  
Health Care System ◽  
Medication Use ◽  
The United States ◽  
Patient Health ◽  
Consumer Perspective ◽  
Medication Experience ◽  
Pharmacist Workforce ◽  
Care System

Pharmacist workforce researchers are predicting a potential surplus of pharmacists in the United States that might result in pharmacists being available for engagement in new roles. The objective for this study was to describe consumer opinions regarding medication use, the health care system, and pharmacists to help identify new roles for pharmacists from the consumer perspective. Data were obtained from the 2015 and 2016 National Consumer Surveys on the Medication Experience and Pharmacist Roles. Out of the representative sample of 36,673 respondents living in the United States, 80% (29,426) submitted written comments at the end of the survey. Of these, 2178 were specifically about medicines, pharmacists or health and were relevant and usable for this study. Thematic analysis, content analysis, and computer-based text mining were used for identifying themes and coding comments. The findings showed that 66% of the comments about medication use and 82% about the health care system were negative. Regarding pharmacists, 73% of the comments were positive with many commenting about the value of the pharmacist for overcoming fears and for filling current gaps in their healthcare. We propose that these comments might be signals that pharmacists could help improve coordination and continuity for peoples’ healthcare and could help guide the development of new service offerings.

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