Impact of an Advanced Imaging Utilization Review Program on Downstream Health Care Utilization and Costs for Low Back Pain
Bibliographic Data
| ID | 14338275 |
|---|---|
| Authors | Janessa M Graves (0000-0002-7659-2634, College of Nursing, Washington State University (WSU), Spokane, corresponding author), Deborah Fulton-Kehoe (Department of Environmental and Occupational Health Sciences, School of Public Health), Deborah Fulton‐Kehoe, Jeffrey G Jarvik (0000-0002-0528-3455, Radiology), Gary M Franklin (0000-0002-1355-4091, Department of Environmental and Occupational Health Sciences, School of Public Health, corresponding author) |
| Year | 2018 |
| Volume | 56 |
| Issue | 6 |
| Pages | 520-528 |
| Publication date | 2018-06-01 |
| Peer Reviewed | Yes |
| Open Access | No |
| Type | ARTICLE |
| Venue | Medical Care (JOURNAL) |
| Journal identifiers | ISSN: 0025-7079 • E-ISSN: 1537-1948 |
| Publisher | Ovid Technologies (Wolters Kluwer Health) (PUBLISHER) |
| DOI | 10.1097/mlr.0000000000000917 |
| PMID | 29668650 |
| OpenAlex | W2800510023 |
| Language | EN |
| Citations received | 1 |
| References cited | 38 |
BACKGROUND: Early magnetic resonance imaging (MRI) for acute low back pain (LBP) has been associated with increased costs, greater health care utilization, and longer disability duration in workers' compensation claimants. OBJECTIVES: To assess the impact of a state policy implemented in June 2010 that required prospective utilization review (UR) for early MRI among workers' compensation claimants with LBP. RESEARCH DESIGN: Interrupted time series. SUBJECTS: In total, 76,119 Washington State workers' compensation claimants with LBP between 2006 and 2014. MEASURES: Proportion of workers receiving imaging per month (MRI, computed tomography, radiographs) and lumbosacral injections and surgery; mean total health care costs per worker; mean duration of disability per worker. Measures were aggregated monthly and attributed to injury month. RESULTS: After accounting for secular trends, decreases in early MRI [level change: -5.27 (95% confidence interval, -4.22 to -6.31); trend change: -0.06 (-0.01 to -0.12)], any MRI [-4.34 (-3.01 to -5.67); -0.10 (-0.04 to -0.17)], and injection [trend change: -0.12 (-0.06 to -0.18)] utilization were associated with the policy. Radiograph utilization increased in parallel [level change: 2.46 (1.24-3.67)]. In addition, the policy resulted in significant decreasing changes in mean costs per claim, mean disability duration, and proportion of workers who received disability benefits. The policy had no effect on computed tomography or surgery utilization. CONCLUSIONS: The UR policy had discernable effects on health care utilization, costs, and disability. Integrating evidence-based guidelines with UR can improve quality of care and patient outcomes, while reducing use of low-value health services
Confidence interval · Health care · Low back pain · Magnetic resonance imaging · Physical therapy · Radiology · Emergency Medicine · Health Systems, Economic Evaluations, Quality of Life · Internal Medicine · Medicine · Musculoskeletal pain and rehabilitation · Spine and Intervertebral Disc Pathology
Conducting Interrupted Time-series Analysis for Single- and Multiple-group Comparisons
Segmented regression analysis of interrupted time series studies in medication use research
How to do (or not to do) … Assessing the impact of a policy change with routine longitudinal data
Improving Quality, Preventing Disability and Reducing Costs in Workers' Compensation Healthcare
| Unique citing works | 1 |
|---|---|
| Citations per year | 1 |
| Citation span | 2025 - 2025 (1) |
| Citation velocity | recent |
| Highly cited | No |
| Citation types | Neutral: 1 |