Why Surgery Rates Vary

Back pain is a critical issue in workers’ compensation, representing nearly one-fifth of the injuries. Although common, how to best treat the injury is controversial and lacks clinical consensus. Moreover, the frequency of surgery among workers with back injuries varies widely from state to state.

This study addresses an important area of inquiry by investigating some of the hypotheses put forward to explain the wide variation in surgery rates. Some of the factors are within the control of workers’ compensation policymakers. Other factors result from the dynamics and practices of the larger health care system. 

The study analyzed workers in 13 states who had work-related back injuries. The authors followed their medical treatment for one year from the date of their injury and examined the factors that were associated with their having surgery or not. The 13 states included in the study are California, Florida, Georgia, Illinois, Indiana, Iowa, Maryland, Michigan, North Carolina, Oklahoma, Pennsylvania, Tennessee, and Texas.

Why Surgery Rates Vary. Christine A. Yee, Steve Pizer, and Olesya Fomenko. June 2015. WC-15-24.


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