Health Serv Res. 2015 Dec;50(6):1927-40. doi: 10.1111/1475-6773.12301. Epub 2015 Mar 16.

Physical Therapy or Advanced Imaging as First Management Strategy Following a New Consultation for Low Back Pain in Primary Care: Associations with Future Health Care Utilization and Charges.

Author information

1: Department of Physical Therapy, College of Health, University of Utah, Salt Lake City, UT.
2: Clinical Quality and Outcomes Research, Intermountain Healthcare, Murray, UT.
3: Intermountain Physical Therapy, Intermountain Healthcare, Salt Lake City, UT.

Abstract

OBJECTIVE:

Compare health care utilization and charges for low-back-pain (LBP) patients receiving advanced imaging or physical therapy as a first management strategy following a new primary care consultation.

DATA SOURCE:

Electronic medical record (EMR) and insurance claims data.

STUDY DESIGN:

Retrospective analysis of propensity-matched groups.

DATA COLLECTION/EXTRACTION:

Claims and EMR data were used. Utilization and LBP-related charges over a 1-year period were extracted from claims data.

PRINCIPAL FINDINGS:

In the propensity-matched sample (n = 406), advanced imaging recipients had higher odds of all utilization outcomes. Charges were higher with advanced imaging by an average $4,793 (95 percent CI: $3,676, $5,910).

CONCLUSIONS:

For patients with LBP whom newly consulted primary care referred for additional management, advanced imaging as a first management was associated with higher health care utilization and charges than physical therapy.