Journal article
The Influence of Patient Choice of First Provider on Costs and Outcomes: Analysis From a Physical Therapy Patient Registry
The journal of orthopaedic and sports physical therapy, Vol.48(2), pp.63-71
02/01/2018
DOI: 10.2519/jospt.2018.7423
PMID: 29073842
Abstract
STUDY DESIGN: Retrospective study.
BACKGROUND: Alternative models of care that allow patients to choose direct access to physical therapy have shown promise in terms of cost reduction for neck and back pain. However, real-world exploration within the US health care system is notably limited.
OBJECTIVES: To compare total claims paid and patient outcomes for patients with neck and back pain who received physical therapy intervention via direct access versus medical referral.
METHODS: Data were accessed for patients seeking care for neck or back pain (n = 603) between 2012 and 2014, who chose to begin care either through traditional medical referral or direct access to a physical therapy-led spine management program. All patients received a standardized, pragmatic physical therapy approach, with patient-reported measures of pain and disability assessed before and after treatment. Patient demographics and outcomes data were obtained from the medical center patient registry and combined with total claims paid calculated for the year after the index claim. Linear mixed-effects modeling was used to analyze group differences in pain and disability, visits/time, and annualized costs.
RESULTS: Patients who chose to enter care via the direct-access physical therapy-led spine management program displayed significantly lower total costs (mean difference, $1543; 95% confidence interval: $51, $3028; P = .04) than those who chose traditional medical referral. Patients in both groups showed clinically important improvements in pain and disability, which were similar between groups (P >. 05).
CONCLUSION: The initial patient choice to begin care with a physical therapist for back or neck pain resulted in lower cost of care over the next year, while resulting in similar improvements in patient outcomes at discharge from physical therapy. These findings add to the emerging literature suggesting that patients' choice to access physical therapy through direct access may be associated with lower health care expenditures for patients with neck and back pain.
Details
- Title: Subtitle
- The Influence of Patient Choice of First Provider on Costs and Outcomes: Analysis From a Physical Therapy Patient Registry
- Creators
- Thomas R. Denninger - ATI Phys Therapy, 200 Patewood Dr,Suite 150C, Greenville, SC 29615 USAChad E. Cook - Duke UniversityCole G. Chapman - University of South CarolinaTimothy McHenry - Greenville Hlth Syst, Steadman Hawkins Clin Carolinas, Greenville, SC USACharles A. Thigpen - ATI Phys Therapy, 200 Patewood Dr,Suite 150C, Greenville, SC 29615 USA
- Resource Type
- Journal article
- Publication Details
- The journal of orthopaedic and sports physical therapy, Vol.48(2), pp.63-71
- Publisher
- J O S P T
- DOI
- 10.2519/jospt.2018.7423
- PMID
- 29073842
- ISSN
- 0190-6011
- eISSN
- 1938-1344
- Number of pages
- 9
- Grant note
- MIT Research Endeavor (MITRE) Corporation
- Language
- English
- Date published
- 02/01/2018
- Academic Unit
- Pharmacy Practice and Science
- Record Identifier
- 9984366027402771
Metrics
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