The study by TAUH Musculoskeletal Centre Orthopaedic Spinal Specialist Heikki Mäntymäki and team investigated regional variation in lumbar spine surgery rates across Finland between 1997 and 2018 using the national Care Register for Health Care (Hilmo). The team examined surgery rates in proportion to population on different university hospital catchment areas. The data set consisted of more than 130,000 surgeries.
“Regional variation in operation rates was very large,” says the main researcher Mäntymäki. “The differences in the rates of lumbar disc herniation surgeries were over fourfold and in lumbar decompression surgeries over threefold.”
Variation in population-based rates of surgical procedures is a worldwide issue. It may be affected by differences in morbidity and pure coincidence, for example. However, manyfold rate variation cannot be explained by these factors.
“The most potent explanatory factors are attitudes towards surgical treatment as well as differences in treatment indications,” says Professor Ville Mattila who led the research. “Wide regional variation in the rates of any treatment indicates that some patients are overtreated, some undertreated. Especially in Finnish healthcare, with equal resources across regions, broad regional variation means that indications for surgical treatment are interpreted differently,” Mattila continues.
The study Regional variations in lumbar spine surgery in Finland was published on 31 December 2021 in Archives of Orthopaedic and Trauma Surgery.