May 2011

Document Type


Degree Name



Dept. of Public Health and Preventive Medicine


Oregon Health & Science University


Study Design: Secondary analysis of Oregon Hospital Discharge Database (OHDDS). Objective: To explore the relationship between payer status and practice variation in lumbar spine surgery in Oregon. Methods: Lumbar fusion patients were extracted from the OHDDS, and payer for each patient was determined. Payer mix was then compared to the state population, the state hospitalized population, and an additional control group of appendectomy patients. Within the group of fusion patients, associations were evaluated between payer and diagnosis, procedure, and instrumentation status. Results: For a lumbar fusion patient, in comparison with a state resident, the crude odds ratio of being insured vs. uninsured is 9.06 (4.73-19.94); the crude odds ratio of having private as opposed to public insurance is 0.54 (0.44-0.65). Compared to an Oregon hospitalized patient, the age-adjusted odds ratio that a lumbar fusion patient has insurance is 3.97 (2.10-7.64); the age-adjusted odds ratio of the fusion




School of Medicine



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