Skip to main content
Journal cover image

Implications of early and guideline adherent physical therapy for low back pain on utilization and costs.

Publication ,  Journal Article
Childs, JD; Fritz, JM; Wu, SS; Flynn, TW; Wainner, RS; Robertson, EK; Kim, FS; George, SZ
Published in: BMC Health Serv Res
April 9, 2015

BACKGROUND: Initial management decisions following a new episode of low back pain (LBP) are thought to have profound implications for health care utilization and costs. The purpose of this study was to evaluate the impact of early and guideline adherent physical therapy for low back pain on utilization and costs within the Military Health System (MHS). METHODS: Patients presenting to a primary care setting with a new complaint of LBP from January 1, 2007 to December 31, 2009 were identified from the MHS Management Analysis and Reporting Tool. Descriptive statistics, utilization, and costs were examined on the basis of timing of referral to physical therapy and adherence to practice guidelines over a 2-year period. Utilization outcomes (advanced imaging, lumbar injections or surgery, and opioid use) were compared using adjusted odds ratios with 99% confidence intervals. Total LBP-related health care costs over the 2-year follow-up were compared using linear regression models. RESULTS: 753,450 eligible patients with a primary care visit for LBP between 18-60 years of age were considered. Physical therapy was utilized by 16.3% (n = 122,723) of patients, with 24.0% (n = 17,175) of those receiving early physical therapy that was adherent to recommendations for active treatment. Early referral to guideline adherent physical therapy was associated with significantly lower utilization for all outcomes and 60% lower total LBP-related costs. CONCLUSIONS: The potential for cost savings in the MHS from early guideline adherent physical therapy may be substantial. These results also extend the findings from similar studies in civilian settings by demonstrating an association between early guideline adherent care and utilization and costs in a single payer health system. Future research is necessary to examine which patients with LBP benefit early physical therapy and determine strategies for providing early guideline adherent care.

Duke Scholars

Altmetric Attention Stats
Dimensions Citation Stats

Published In

BMC Health Serv Res

DOI

EISSN

1472-6963

Publication Date

April 9, 2015

Volume

15

Start / End Page

150

Location

England

Related Subject Headings

  • Young Adult
  • United States
  • Physical Therapy Modalities
  • Odds Ratio
  • Middle Aged
  • Male
  • Low Back Pain
  • Linear Models
  • Humans
  • Hospitals, Military
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Childs, J. D., Fritz, J. M., Wu, S. S., Flynn, T. W., Wainner, R. S., Robertson, E. K., … George, S. Z. (2015). Implications of early and guideline adherent physical therapy for low back pain on utilization and costs. BMC Health Serv Res, 15, 150. https://doi.org/10.1186/s12913-015-0830-3
Childs, John D., Julie M. Fritz, Samuel S. Wu, Timothy W. Flynn, Robert S. Wainner, Eric K. Robertson, Forest S. Kim, and Steven Z. George. “Implications of early and guideline adherent physical therapy for low back pain on utilization and costs.BMC Health Serv Res 15 (April 9, 2015): 150. https://doi.org/10.1186/s12913-015-0830-3.
Childs JD, Fritz JM, Wu SS, Flynn TW, Wainner RS, Robertson EK, et al. Implications of early and guideline adherent physical therapy for low back pain on utilization and costs. BMC Health Serv Res. 2015 Apr 9;15:150.
Childs, John D., et al. “Implications of early and guideline adherent physical therapy for low back pain on utilization and costs.BMC Health Serv Res, vol. 15, Apr. 2015, p. 150. Pubmed, doi:10.1186/s12913-015-0830-3.
Childs JD, Fritz JM, Wu SS, Flynn TW, Wainner RS, Robertson EK, Kim FS, George SZ. Implications of early and guideline adherent physical therapy for low back pain on utilization and costs. BMC Health Serv Res. 2015 Apr 9;15:150.
Journal cover image

Published In

BMC Health Serv Res

DOI

EISSN

1472-6963

Publication Date

April 9, 2015

Volume

15

Start / End Page

150

Location

England

Related Subject Headings

  • Young Adult
  • United States
  • Physical Therapy Modalities
  • Odds Ratio
  • Middle Aged
  • Male
  • Low Back Pain
  • Linear Models
  • Humans
  • Hospitals, Military