Impact of co-morbidities on resource use and adherence to guidelines among commercially insured adults with new visits for back pain

Journal of Evaluation in Clinical Practice
Sean D RundellBrian W Bresnahan

Abstract

To assess if co-morbidity is associated with higher use of back-related care and adherence to back pain guidelines. We conducted a retrospective cohort study using administrative claims data from 2007-2011. We included individuals ≥18 years with an index visit for back pain. Co-morbidities were measured 12 months prior to index. Co-morbidity burden was measured using Quan's Co-morbidity Index. Co-morbidities categories were measured using chronic condition indicators from the Agency for Healthcare Research and Quality. Total lumbar spine-related resource use for three years was ascertained using procedure codes. A clustering algorithm identified higher long-term utilizer. We identified initial use from day 0-42 for several categories of spine-related care. We used logistic regression to test the association between co-morbidities and resource use. Greater co-morbidity burden was associated with higher long-term spine-related resource use. Those with ≥2 on Quan's Co-morbidity Index had 29% higher odds of being a high back-specific resource user compared to those with no co-morbidities [Odds Ratio (OR): 1.29, 95% Confidence Interval (CI): 1.23-1.35]. Greater co-morbidity burden was associated with more frequent initial use of ima...Continue Reading

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Citations

Apr 10, 2018·The Journal of Orthopaedic and Sports Physical Therapy·Steven Z GeorgeGiorgio Zeppieri
Mar 28, 2020·European Journal of Physical and Rehabilitation Medicine·Fabio ZainaStefano Negrini
Jul 5, 2019·Journal of Evaluation in Clinical Practice·Yannick Tousignant-LaflammeOlivier Tri-Trinh Lam
Dec 15, 2020·Journal of Clinical Pharmacy and Therapeutics·Autumn WalkerlyMate Soric
Jun 27, 2021·The Journal of Pain : Official Journal of the American Pain Society·Divyan ChopraBradley C Martin

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