Lumbar surgery readmission rates higher in comp than group health

Workers compensation patients who undergo lumbar surgeries have higher percentages of reoperation and readmission compared to those undergoing similar surgeries in group health, the Workers Compensation Research Institute reported in a study released Thursday.

Cambridge, Massachusetts-based WCRI researchers examined 30- and 90-day reoperation and readmission rates for injured workers who underwent lumbar spine surgeries in 18 states from October 2015 to October 2016, and followed the patients’ post-operative experiences until April 2018.

The study found that 7% of workers compensation patients undergoing lumbar surgery have a reoperation or readmission within 30 days and 8% undergo reoperation or readmission within 90 days, a rate two to seven times higher than the rate of reoperation or readmission for non-workers compensation patients.

Researchers also found that total medical payments per claim for lumbar surgery with readmission or rehospitalization resulted in payments that were up to 260% higher than in cases without. Surgery and hospitalization payments per claim for cases with readmission ranged from $21,000 to more than $75,000, according to the study.

The study did find substantial difference among readmission and reoperation rates across the study states, noting that in North Carolina, one in 10 workers was readmitted within two years of surgery, while more than one in five workers comp patients who received surgery in that state underwent reoperation or were readmitted.

Researchers said these results “shed light on the areas where quality improvement is most needed” in workers compensation.

The states involved in the study include Arkansas, California, Florida, Georgia, Illinois, Indiana, Iowa, Louisiana, Massachusetts, Michigan, Minnesota, New Jersey, North Carolina, Pennsylvania, Tennessee, Texas, Virginia and Wisconsin.

This article was first published in Business Insurance.

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