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

• Published in: Health services research 2015-12, Vol.50 (6), p.1927-1940
• Main Authors: Fritz, Julie M., Brennan, Gerard P., Hunter, Stephen J.
• Format: Article
• Language: English
• Subjects: Adult; Appropriate Imaging Use; Back pain; Backache; Care and treatment; Claims; Clinical outcomes; Comorbidity; Company business management; Consultation; Data acquisition; Data collection; Data processing; Diagnostic Imaging - economics; Electronic Health Records; Evidence-based medicine; Extraction; Female; Health care; Health insurance; Health services; Health Services Research; Health services utilization; Health status; Help seeking behavior; Humans; imaging; Insurance; Insurance Claim Review; Low back pain; Low Back Pain - diagnosis; Low Back Pain - rehabilitation; Male; Management; Medical care; Medical care utilization; Medical electronics; Medical imaging; Medical records; Middle Aged; Pain; Pain management; Patients; Physical therapy; Physical Therapy Modalities - economics; Physiotherapy; Primary care; Primary Health Care - organization & administration; Research Briefs; Retrospective Studies; Strategic planning (Business); Studies; Therapeutics, Physiological; Therapy; Utilization
• ISSN: 0017-9124; 1475-6773
• DOI: 10.1111/1475-6773.12301

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.