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Do the Number of Visits and the Cost of Musculoskeletal Care Improve Outcomes? More May Not Be Better.

Publication ,  Journal Article
Clewley, D; Iftikhar, Y; Horn, ME; Rhon, DI
Published in: J Orthop Sports Phys Ther
November 2020

OBJECTIVES: To determine the relationship between health care use and the magnitude of change in patient-reported outcomes in individuals who received treatment for subacromial pain syndrome. The secondary objective was to determine the value of care, as measured by change in pain and disability per dollar spent. DESIGN: Secondary analysis of a randomized clinical trial that investigated the effects of nonsurgical care for subacromial pain syndrome. METHODS: Two groups of treatment responders were created, based on 1-year change in Shoulder Pain and Disability Index (SPADI) score (high, 46.83 points; low, 8.21 points). Regression analysis was performed to determine the association between health care use and 1-year change in SPADI score. Baseline SPADI score was used as a covariate in the regression analysis. Value was measured by comparing health care visits and costs expended per SPADI 1-point change between responder groups. RESULTS: Ninety-eight patients were included; 38 were classified as high responders (mean 1-year SPADI change score, 46.83 points) and 60 were classified as low responders (1-year SPADI change score, 8.21 points). Neither unadjusted medical visits (5.89; 95% confidence interval [CI]: 4.35, 7.44 versus 6.30; 95% CI: 5.14, 7.46) nor medical costs ($1404.86; 95% CI: $1109.34, $1779.09 versus $1679.26; 95% CI: $1391.54, $2026.48) were significantly different between high and low responders, respectively. CONCLUSION: Neither the number of visits nor the financial cost of nonsurgical shoulder- related care was associated with improvement in shoulder pain and disability at 1 year. J Orthop Sports Phys Ther 2020;50(11):642-648. doi:10.2519/jospt.2020.9440.

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Published In

J Orthop Sports Phys Ther

DOI

EISSN

1938-1344

Publication Date

November 2020

Volume

50

Issue

11

Start / End Page

642 / 648

Location

United States

Related Subject Headings

  • Shoulder Pain
  • Shoulder Impingement Syndrome
  • Patient Reported Outcome Measures
  • Orthopedics
  • Office Visits
  • Musculoskeletal Manipulations
  • Military Health Services
  • Middle Aged
  • Male
  • Humans
 

Citation

APA
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Clewley, D., Iftikhar, Y., Horn, M. E., & Rhon, D. I. (2020). Do the Number of Visits and the Cost of Musculoskeletal Care Improve Outcomes? More May Not Be Better. J Orthop Sports Phys Ther, 50(11), 642–648. https://doi.org/10.2519/jospt.2020.9440
Clewley, Derek, Yusra Iftikhar, Maggie E. Horn, and Daniel I. Rhon. “Do the Number of Visits and the Cost of Musculoskeletal Care Improve Outcomes? More May Not Be Better.J Orthop Sports Phys Ther 50, no. 11 (November 2020): 642–48. https://doi.org/10.2519/jospt.2020.9440.
Clewley D, Iftikhar Y, Horn ME, Rhon DI. Do the Number of Visits and the Cost of Musculoskeletal Care Improve Outcomes? More May Not Be Better. J Orthop Sports Phys Ther. 2020 Nov;50(11):642–8.
Clewley, Derek, et al. “Do the Number of Visits and the Cost of Musculoskeletal Care Improve Outcomes? More May Not Be Better.J Orthop Sports Phys Ther, vol. 50, no. 11, Nov. 2020, pp. 642–48. Pubmed, doi:10.2519/jospt.2020.9440.
Clewley D, Iftikhar Y, Horn ME, Rhon DI. Do the Number of Visits and the Cost of Musculoskeletal Care Improve Outcomes? More May Not Be Better. J Orthop Sports Phys Ther. 2020 Nov;50(11):642–648.

Published In

J Orthop Sports Phys Ther

DOI

EISSN

1938-1344

Publication Date

November 2020

Volume

50

Issue

11

Start / End Page

642 / 648

Location

United States

Related Subject Headings

  • Shoulder Pain
  • Shoulder Impingement Syndrome
  • Patient Reported Outcome Measures
  • Orthopedics
  • Office Visits
  • Musculoskeletal Manipulations
  • Military Health Services
  • Middle Aged
  • Male
  • Humans