Spine
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Prior literature has demonstrated that disparities exist in health care access and outcomes by insurance status, and patients with commercial plans fare better than those with Medicaid. However, variation may exist within commercial plans, which may impact care access. The purpose of our study was to determine the association between commercial health insurance plan type and access/time to surgery among patients with degenerative cervical conditions. ⋯ Insurance plan structure has a significant impact on incidence of and on time-to-occurrence of surgery for patients with cervical degenerative conditions. Patients with HDHP plans may experience higher costs, potentially limiting access to care.
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A retrospective analysis. ⋯ Sensitivity-based and specificity-based methods provide statistically sound minimum clinically important difference thresholds for the DNDLS population. The minimum clinically important difference thresholds for PROMs in patients with DNDLS were different from the threshold values previously reported for adult patients with spinal deformities.
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Systematic review and meta-analysis. ⋯ Level II.
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Qualitative interview study. ⋯ Our Spine Surgery Recovery conceptual model provides guidance for future research and clinical practice to optimize treatment and improve overall patient satisfaction. Recommendations based on this model include the assessment of patient expectations and mental well-being throughout postoperative recovery as well as preoperatively to help set realistic expectations and improve satisfaction. Educational, acceptance-based or positive psychological interventions may be potentially beneficial for addressing key factors identified in this model.