Behandlingsrater for ryggkirurgi i Norge og Helse Nord 2014–18

Ingebrigtsen, Tor; Balteskard, Lise; Guldhaugen, Kristel Ailin; Kloster, Roar; Uleberg, Bård; Grotle, Margreth

doi:10.4045/tidsskr.20.0313

Cited by 6 publications

(12 citation statements)

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“…Most articles (n = 30) used administrative healthcare databases for the analyses. Three articles used national spine registries for data collection, [24][25][26] and one article used hospital records. 27 In all but three articles, 25,28,29 significant variation of surgical rates was concluded by the authors.…”

Section: Resultsmentioning

confidence: 99%

Practice Variation Research in Degenerative Lumbar Disc Surgery: A Literature Review on Design Characteristics and Outcomes

Munster

Weerdt

Halperin

et al. 2021

Global Spine Journal

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Study Design Literature review. Objective To describe whether practice variation studies on surgery in patients with lumbar degenerative disc disease used adequate study methodology to identify unwarranted variation, and to inform quality improvement in clinical practice. Secondary aim was to describe whether variation changed over time. Methods Literature databases were searched up to May 4th, 2021. To define whether study design was appropriate to identify unwarranted variation, we extracted data on level of aggregation, study population, and case-mix correction. To define whether studies were appropriate to achieve quality improvement, data were extracted on outcomes, explanatory variables, description of scientific basis, and given recommendations. Spearman’s rho was used to determine the association between the Extreme Quotient (EQ) and year of publication. Results We identified 34 articles published between 1990 and 2020. Twenty-six articles (76%) defined the diagnosis. Prior surgery cases were excluded or adjusted for in 5 articles (15%). Twenty-three articles (68%) adjusted for case-mix. Variation in outcomes was analyzed in 7 articles (21%). Fourteen articles (41%) identified explanatory variables. Twenty-six articles (76%) described the evidence on effectiveness. Recommendations for clinical practice were given in 9 articles (26%). Extreme Quotients ranged between 1-fold and 15-fold variation and did not show a significant change over time (rho= −.33, P= .09). Conclusions Practice variation research on surgery in patients with degenerative disc disease showed important limitations to identify unwarranted variation and to achieve quality improvement by public reporting. Despite the availability of new evidence, we could not observe a significant decrease in variation over time.

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Section: Resultsmentioning

confidence: 99%

Practice Variation Research in Degenerative Lumbar Disc Surgery: A Literature Review on Design Characteristics and Outcomes

Munster

Weerdt

Halperin

et al. 2021

Global Spine Journal

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“…Vi har tidligere rapportert at raten for kirurgisk behandling av degenerative rygglidelser i Norge økte fra 78 til 120 operasjoner per 100 000 innbyggere per år fra 1999 til 2013 (5). Raten lå dere er stabilt på omkring 120 operasjoner per 100 000 innbyggere per år i perioden 2014-18 (6). I Helse Nord var raten for avstivingsoperasjoner og/eller operasjoner med annen instrumentering og egendekningen for all kirurgisk behandling av degenerative rygglidelser lavere enn i resten av landet (6).…”

Section: H Ov E D F U N Nunclassified

“…Raten lå dere er stabilt på omkring 120 operasjoner per 100 000 innbyggere per år i perioden 2014-18 (6). I Helse Nord var raten for avstivingsoperasjoner og/eller operasjoner med annen instrumentering og egendekningen for all kirurgisk behandling av degenerative rygglidelser lavere enn i resten av landet (6). Nakkekirurgi er sentralisert til de nevrokirurgiske avdelingene ved regionsykehusene.…”

Section: H Ov E D F U N Nunclassified

“…Universitetssykehuset Nord-Norge utfører over 80 % av ryggkirurgien for bosa e i Helse Nord (6), og er det eneste i regionen som utfører nakkekirurgi. Det er derfor naturlig å se ratene for rygg-og nakkekirurgi under e i vurdering av regionens behandlingskapasitet og tilgjengeligheten til behandlingstilbudet.…”

Section: H Ov E D F U N Nunclassified

“…Vår tilsvarende beregning for ryggkirurgi estimerte behov for å øke aktiviteten med om lag 170 operasjoner per år (6). Beregningene indikerer til sammen en underdekning for spinalkirurgi på om lag 200 operasjoner per år i Helse Nord.…”

Section: U R D E R I N G Av a K T I V I T E T I H E L S E N O R Dunclassified

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Nakkekirurgi i Helse Nord 2014–18

Ingebrigtsen¹,

Guldhaugen²,

Kristiansen³

et al. 2022

Tidsskriftet

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The Norwegian registry for spine surgery (NORspine): cohort profile

Mikkelsen,

Ingebrigtsen,

Thyrhaug

et al. 2023

Eur Spine J

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Purpose To review and describe the development, methods and cohort of the lumbosacral part of the Norwegian registry for spine surgery (NORspine). Methods NORspine was established in 2007. It is government funded, covers all providers and captures consecutive cases undergoing operations for degenerative disorders. Patients’ participation is voluntary and requires informed consent. A set of baseline-, process- and outcome-variables (3 and 12 months) recommended by the International Consortium for Health Outcome Measurement is reported by surgeons and patients. The main outcome is the Oswestry disability index (ODI) at 12 months. Results We show satisfactory data quality assessed by completeness, timeliness, accuracy, relevance and comparability. The coverage rate has been 100% since 2016 and the capture rate has increased to 74% in 2021. The cohort consists of 60,647 (47.6% women) cases with mean age 55.7 years, registered during the years 2007 through 2021. The proportions > 70 years and with an American Society of Anaesthesiologists’ Physical Classification System (ASA) score > II has increased gradually to 26.1% and 19.3%, respectively. Mean ODI at baseline was 43.0 (standard deviation 17.3). Most cases were operated with decompression for disc herniation (n = 26,557, 43.8%) or spinal stenosis (n = 26,545, 43.8%), and 7417 (12.2%) with additional or primary fusion. The response rate at 12 months follow-up was 71.6%. Conclusion NORspine is a well-designed population-based comprehensive national clinical quality registry. The register’s methods ensure appropriate data for quality surveillance and improvement, and research.

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Behandlingsrater for ryggkirurgi i Norge og Helse Nord 2014–18

Cited by 6 publications

References 12 publications

Practice Variation Research in Degenerative Lumbar Disc Surgery: A Literature Review on Design Characteristics and Outcomes

Practice Variation Research in Degenerative Lumbar Disc Surgery: A Literature Review on Design Characteristics and Outcomes

Nakkekirurgi i Helse Nord 2014–18

The Norwegian registry for spine surgery (NORspine): cohort profile

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