Management of Neck or Back Pain in Ambulatory Care

Did Visit Mode or the Covid-19 Pandemic Affect Provider Practice or Patient Adherence

Datos Bibliográficos

ID9102628
AutoresDouglas W Roblin (Kaiser Permanente, Mid-Atlantic Permanente Research Institute, Rockville, MD, autor de correspondencia), Glenn K Goodrich (0000-0002-0487-0682, Kaiser Permanente, Institute for Health Research, Denver, CO), Teaniese L Davis (0000-0001-7408-0291, Kaiser Permanente), Jennifer C Gander (0000-0002-4798-0750, Kaiser Permanente), Courtney E McCracken (0000-0001-7941-1256, Kaiser Permanente), Nancy S Weinfield (0000-0002-1417-2271, Kaiser Permanente, Mid-Atlantic Permanente Research Institute, Rockville, MD, autor de correspondencia), Debra P Ritzwoller (0000-0001-7116-8458, Kaiser Permanente, Institute for Health Research, Denver, CO)
Año2023
Volumen61
NúmeroSuppl 1
PáginasS30-S38
Fecha de publicación2023-04-01
Peer ReviewedSí
Open AccessNo
TipoARTICLE
RevistaMedical Care (JOURNAL)
Identificadores de la revistaISSN: 0025-7079 • E-ISSN: 1537-1948
EditorialOvid Technologies (Wolters Kluwer Health) (PUBLISHER)
DOI10.1097/mlr.0000000000001833
PMID36893416
OpenAlexW4323655890
IdiomaEN
Citas recibidas2
Referencias citadas50

BACKGROUND/OBJECTIVE: In recent years, 2 circumstances have changed provider-patient interactions in ambulatory care: (1) the replacement of virtual for in-person visits and (2) the COVID-19 pandemic. We studied the potential impact of each event on provider practice and patient adherence by comparing the frequency of the association of provider orders, and patient fulfillment of those orders, by visit mode and pandemic period, for incident neck or back pain (NBP) visits in ambulatory care. METHODS: Data were extracted from the electronic health records of 3 Kaiser Permanente regions (Colorado, Georgia, and Mid-Atlantic States) from January 2017 to June 2021. Incident NBP visits were defined from ICD-10 coded as primary or first listed diagnoses on adult, family medicine, or urgent care visits separated by at least 180 days. Visit modes were classified as virtual or in-person. Periods were classified as prepandemic (before April 2020 or the beginning of the national emergency) or recovery (after June 2020). Percentages of provider orders for, and patient fulfillment of orders, were measured for 5 service classes and compared on: virtual versus in-person visits, and prepandemic versus recovery periods. Comparisons were balanced on patient case-mix using inverse probability of treatment weighting. RESULTS: Ancillary services in all 5 categories at each of the 3 Kaiser Permanente regions were substantially ordered less frequently on virtual compared with in-person visits in both the prepandemic and recovery periods (both P ≤ 0.001). Conditional on an order, patient fulfillment within 30 days was high (typically ≥70%) and not likely meaningfully different between visit modes or pandemic periods. CONCLUSIONS: Ancillary services for incident NBP visits were ordered less frequently during virtual than in-person visits in both prepandemic and recovery periods. Patient fulfillment of orders was high, and not significantly different by mode or period

Alternative medicine · Ambulatory · Ambulatory care · Family medicine · Health care · Medical emergency · MEDLINE · Neck pain · Patient satisfaction · COVID-19 and healthcare impacts · Emergency Medicine · Internal Medicine · Medicine · Musculoskeletal pain and rehabilitation · Nursing · Telemedicine and Telehealth Implementation