A stratified care model for low back pain: healthcare utilization in primary care

Presenter's Name(s)

Kara M. Pflaster, UVMFollow

Conference Year

January 2019

Abstract

Introduction

The aim of this study was to compare healthcare utilization data between a clinical trial (CT) cohort, a quality improvement research (QIR) cohort, and a retrospective (RT) cohort of patients with low back pain (LBP). Specifically, this study examined if there was a reduction in healthcare utilization among the three cohorts which, if found, would further support the implementation of the stratified model of care in primary care. The stratified care model includes risk stratification based on the Keele STarT Back Screening Tool (SBT) plus a physical therapy (PT) matched to the patient’s risk level.

Methods

The CT cohort participated in a study between February 2017 – January 2018 that aimed to determine the effectiveness of a stratified care model for the treatment of non-specific LBP compared to the current care practice in the Departments of Rehabilitation Therapy and of Family Medicine (FM) at the UVM Medical Center. The QIR cohort included patients who were seen in FM for LBP between February 2018 – December 2018 and who were to receive the stratified model of care. The RT cohort included patients seen in FM for LBP between October 2015 – September 2016 whose data were extracted for comparison. Healthcare utilization data included the number of imaging events, emergency department visits, medications prescribed, SBT administered and PT referrals.

Results

Across the cohorts, the number of imaging events was lowest in the CT cohort (14.9%), and highest in the QIR cohort (20%), while the RT cohort had 17% of patients with imaging for their LBP. There were no difference among the three cohorts for emergency department visits for LBP. Analyses of healthcare utilization data are ongoing.

Conclusions

Examination of healthcare utilization data will help inform decisions about the implementation of the stratified care model in primary care.

Primary Faculty Mentor Name

Sharon Henry, PT, PhD

Secondary Mentor Name

Alison Holm, PhD, Amanda Kolb, MD

Status

Undergraduate

Student College

College of Agriculture and Life Sciences

Program/Major

Biology

Second Program/Major

Political Science

Primary Research Category

Health Sciences

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A stratified care model for low back pain: healthcare utilization in primary care

Introduction

The aim of this study was to compare healthcare utilization data between a clinical trial (CT) cohort, a quality improvement research (QIR) cohort, and a retrospective (RT) cohort of patients with low back pain (LBP). Specifically, this study examined if there was a reduction in healthcare utilization among the three cohorts which, if found, would further support the implementation of the stratified model of care in primary care. The stratified care model includes risk stratification based on the Keele STarT Back Screening Tool (SBT) plus a physical therapy (PT) matched to the patient’s risk level.

Methods

The CT cohort participated in a study between February 2017 – January 2018 that aimed to determine the effectiveness of a stratified care model for the treatment of non-specific LBP compared to the current care practice in the Departments of Rehabilitation Therapy and of Family Medicine (FM) at the UVM Medical Center. The QIR cohort included patients who were seen in FM for LBP between February 2018 – December 2018 and who were to receive the stratified model of care. The RT cohort included patients seen in FM for LBP between October 2015 – September 2016 whose data were extracted for comparison. Healthcare utilization data included the number of imaging events, emergency department visits, medications prescribed, SBT administered and PT referrals.

Results

Across the cohorts, the number of imaging events was lowest in the CT cohort (14.9%), and highest in the QIR cohort (20%), while the RT cohort had 17% of patients with imaging for their LBP. There were no difference among the three cohorts for emergency department visits for LBP. Analyses of healthcare utilization data are ongoing.

Conclusions

Examination of healthcare utilization data will help inform decisions about the implementation of the stratified care model in primary care.