Adherence to established clinical practice guidelines could reduce high downstream healthcare utilization.
Musculoskeletal pain as a whole is a common and costly health condition. Up to 84% of the general population will report at least one episode of low back pain (LBP) at some point in their life. This high rate of LBP treatment also has high downstream costs. An article published in PLOS One systematically reviews a collection of peer reviewed studies to evaluate the influence of physical therapy guideline adherence on healthcare utilization and costs for LBP patients.
Hanney et al conducted an electronic search across various peer-reviewed journals to assess current evidence on how guideline adherence affects LBP costs. The authors identified seven primary factors for healthcare utilization and costs:
- Number and duration of PT visits
- Prescription medication use
- Physician office visits
- Emergency department care
- Advanced imaging
- Surgical procedures
- Injection procedures
With some exceptions, the review showed that those participating in an adherent PT treatment program experience lower healthcare utilization. This includes fewer and shorter PT visits, fewer medications, fewer visits to the physicians or emergency department and less use of advanced imaging, surgical, and injection procedures.
While further research is needed to provide firm evidence on the impact of guideline adherence among patients with LBP, this preliminary evidence is a great step towards optimized effectiveness and efficiency in value-based healthcare systems.
That’s why MedRisk invested in the development and on-going maintenance of physical medicine specific evidence-based treatment guidelines. These guidelines take into consideration chronicity (the age of the injury), complexity (multiple body parts and/or comorbidities), severity and surgery. They also address the best treatment choice, timing, and sequence of interventions. Their specificity make them a valuable supplement to ODG, ACOEM, and state-specific guidelines. MedRisk’s proprietary guidelines, developed and maintained by our International Scientific Advisory Board, allow us to proactively identify cases that may be trending off track and support clinical decision-making—ultimately eliminating unnecessary downstream utilization and costs.
To read the full article, click here.
Hanney WJ, Masaracchio M, Liu X, Kolber MJ. The Influence of Physical Therapy Guideline Adherence on Healthcare Utilization and Costs among Patients with Low Back Pain: A Systematic Review of the Literature. PLoS One. 2016 Jun 10;11(6):e0156799. doi: 10.1371/journal.pone.0156799. PMID: 27285608; PMCID: PMC4902217.