Outcomes of Sacral Neuromodulation in a Privately Insured Population.
Outcomes of Sacral Neuromodulation in a Privately Insured Population.
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DOI：
10.1111/ner.12472
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发表时间：
2016-10
期刊：
影响因子：
--
通讯作者：
Urologic Diseases in America Project
中科院分区：
文献类型：
--
作者：
Anger JT;Cameron AP;Madison R;Saigal C;Clemens JQ;Urologic Diseases in America Project
在本研究中，我们分析了来自Ingenix数据库的索赔数据，以分析骶神经调节的结局与提供者和患者因素有关。我们使用Ingenix（I3）数据库来确定2002-2007年私人保险患者的人口统计学、诊断和手术成功信息。根据ICD-9诊断代码和现行手术术语程序代码，获得人口统计学信息以及给出的诊断和进行的手术。进行多变量分析以确定成功的特定预测因素，如通过植入脉冲发生器的进展所测量的。根据电池放置定义的总体成功率为49.1%。51%的分期手术后进行了电池放置，而经皮病例为24.1%（p < 0.0001）。在分析的患者变量中，女性比男性更有可能进展到电池放置。在I期测试后，泌尿科医生治疗的患者总体上比妇科医生更有可能进行电池放置（I3：54% vs. 47%，p < 0.0001）。与以前在其他基于声明的数据集中的发现不同，我们在i3数据集中没有观察到提供商-卷关系。正式分期手术后，骶神经调节的成功率（通过进行电池放置来定义）要好得多，这使我们质疑经皮技术的实用性。女性患者和泌尿科医生治疗的患者的结局也更好。随着越来越多的妇科医生采用骶神经调节，专业差异可能会随着时间的推移而减少。
In this study, we analyzed claims data from the Ingenix data base to analyze outcomes of sacral neuromodulation with respect to both provider and patient factors. We used the Ingenix (I3) data base to determine demographic, diagnosis, and procedure success information for years 2002–2007 for privately insured patients. Demographic information was obtained, as were the diagnoses given and procedures performed, based on ICD-9 diagnosis codes and Current Procedural Terminology procedure codes. Multivariate analysis was performed to identify specific predictors of success, as measured by progression to implantation of a pulse generator. Overall success, as defined by battery placement, was 49.1%. Fifty-one percent of staged procedures were followed by battery placement compared with 24.1% of percutaneous cases (p < 0.0001). Among the patient variables analyzed, women were more likely than men to progress to battery placement. After Stage I testing, patients treated by urologists were overall more likely than gynecologists to proceed to battery placement (I3: 54% vs. 47%, p < 0.0001). Unlike previous findings in other claims-based data sets, we did not observe a provider-volume relationship in the i3 data set. Success of sacral neuromodulation, as defined by proceeding to battery placement, was much better after formal staged procedures, which leads us to question the utility of percutaneous techniques. Outcomes were also better among female patients and among those treated by a urologist. Specialty differences will likely diminish over time as more gynecologists adopt sacral neuromodulation.
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影响因子：
2.1
作者：
Amundsen, CL;Romero, AA;Webster, GD
通讯作者：
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影响因子：
6.6
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影响因子：
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通讯作者：
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影响因子：
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作者：
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通讯作者：
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