未经证实:下腰痛(LBP)是美国最需要康复的健康状况。管理LBP的财务负担也是美国最高的。临床实践指南(CPG)提供管理建议,并有可能降低健康成本。关于CPG实施对下游医疗费用的影响的证据有限。
UNASSIGNED:研究在物理治疗师(PT)实践中实施CPG对LBP患者的直接和下游成本的影响。
UNASSIGNED:一项回顾性观察性研究检查了270名LBP患者的账单数据,这些患者在一个大型学术医疗中心的多个地点接受了PT的治疗,这些患者参与了多方面的CPG实施计划。对直接PT服务的成本进行了分析,下游医疗服务,2017年9月至2018年3月(实施前小组)和PT利用率,并与2018年6月至2018年12月(实施后小组)的成本进行比较。
UNASSIGNED:实施后的直接PT成本显着低于实施前的平均值:2,863美元(SD:1,968美元)与3,459美元(SD:2,838美元),p=0.05,95%CI[11,1182]。实施后所有下游成本均较低,下游成像成本具有统计学意义:p=.04,95%CI[32,1,905];药房:p=.03,95%CI[70,1,217];手术:p=.03,95%CI[446,9,152],和“其他”:p=.02,95%CI[627,7920]。
UNASSIGNED:在门诊PT实践中实施LBPCPG可以对降低下游成本和增加PT服务价值的潜力产生积极影响。
UNASSIGNED: Low back pain (LBP) is the top health condition requiring rehabilitation in the United States. The financial burden of managing LBP is also amongst the highest in the United States. Clinical practice
guidelines (CPGs) provide management recommendations and have the potential to lower health costs. Limited evidence exists on the impact of CPG implementation on downstream medical costs.
UNASSIGNED: To examine the impact of CPG implementation in physical therapist (PT) practice on direct and downstream costs for patients with LBP.
UNASSIGNED: A retrospective observational study examined billing data from 270 patients with LBP who were treated at multiple sites within one large academic medical center by PTs who participated in a multifaceted CPG implementation program. Costs were analyzed for direct PT services, downstream medical services, and PT utilization from September 2017 to March 2018 (pre-implementation group) and compared with costs from June 2018 to December 2018 (post-implementation group).
UNASSIGNED: Direct PT costs were significantly lower post-implementation than pre-implementation mean: $2,863 USD (SD: $1,968) vs. $3,459 USD (SD: $2,838), p = .05, 95% CI [11, 1182]. All downstream costs were lower post-implementation with statistically significant lower costs found in downstream imaging: p = .04, 95% CI [32, 1,905]; pharmacy: p = .03, 95% CI [70, 1,217]; surgery: p = .03, 95% CI [446, 9,152], and \"other\": p = .02, 95% CI [627, 7,920].
UNASSIGNED: Implementing the LBP CPG in outpatient PT practice can have a positive impact on lowering downstream costs and the potential to increase the value of PT services.