• E Volinn, K M Turczyn, and J D Loeser.
• Multidisciplinary Pain Center, University of Washington, Seattle 98195.
• Clin J Pain. 1994 Mar 1;10(1):64-70.

ObjectiveTo examine patterns in both surgical and nonsurgical low back pain (LBP) hospitalizations through time and among geographic regions and to explore the practical implications of these patterns for health care reform.SettingFor time trends, the U.S. (1979-1987); for geographic variations, major regions of the U.S. (1987). DATE SOURCE: The National Hospital Discharge Survey.ResultsRates of both surgical and nonsurgical LBP hospitalization varied twofold among regions of the U.S., and average lengths of stay for these types of hospitalization varied considerably as well. The U.S. rate of LBP surgery increased sharply during the period covered by the study. Over the same time, the U.S. rate of nonsurgical LBP hospitalization declined, as did average lengths of stay for both types of LBP hospitalization.ConclusionWide variations in LBP hospitalization practices raise the issue of which practices are most appropriate. Outcomes research addresses this issue, as does research on patient preferences for certain types of treatment. As indicated by the increasing rate of LBP surgery, more research also needs to be done on changing physician practice style. If such research were to result in a reduction in LBP hospitalization, savings in health care costs would be considerable.

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