Reoperation & Readmission Rates for Workers’ Compensation Patients Undergoing Lumbar Surgery

By Rebecca (Rui) Yang, Randall Lea, M.D.

October 29, 2020 Related Topics: Medical Costs, Worker Outcomes

Post-surgery readmissions and reoperations are the primary quality indicators being used by commercial, governmental, and a limited number of workers’ compensation payors in their value-based purchasing programs. This study can help policymakers and other stakeholders shed light on the areas where quality improvement is most needed. It can also prove to be useful to patients as they consider treatment options.

The study quantifies the 30-day and 90-day reoperation and readmission rates for workers’ compensation patients undergoing lumbar spine surgeries, and compares these rates with those for non-workers’ compensation patients reported by other studies. It also discusses the major types of reoperations and the main reasons for readmissions, examines medical payments per claim, and describes interstate variation in the prevalence of reoperation and readmission. 

The analysis for this report focuses on workers with low back pain who underwent either lumbar discectomy/decompression or lumbar fusion surgery in 18 states for injuries that arose between October 1, 2015, and September 30, 2016, and follows the postoperative experience for each case through March 31, 2018. The 18 study states, which represent 61 percent of all workers’ compensation benefits paid nationwide, are Arkansas, California, Florida, Georgia, Illinois, Indiana, Iowa, Louisiana, Massachusetts, Michigan, Minnesota, New Jersey, North Carolina, Pennsylvania, Tennessee, Texas, Virginia, and Wisconsin. 

Reoperation & Readmission Rates for Workers' Compensation Patients Undergoing Lumbar Surgery. Rebecca Yang and Randy Lea. October 2020. WC-20-44.


Copyright: WCRI

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Research Questions:

• What are the rates of reoperation and readmission for workers’ compensation patients undergoing lumbar spine surgery? 
• How do readmission and reoperation rates after lumbar surgery among workers’ compensation patients compare with other payor groups? 
• What are the major types of reoperation and the major reasons for readmission observed among workers’ compensation patients undergoing lumbar spine surgery? 
• What are the medical payments per claim for lumbar surgery cases involving readmission and reoperation for workers’ compensation patients? How do medical payments for these cases with reoperation and readmission compare with the cases without? 
• How much does the prevalence of reoperation and readmission vary across states? 

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