Excerpt from a clinical study currently in peer review.
TITLE: Healthcare utilization and cost of care for a multidisciplinary integrated practice unit model of spine rehabilitation compared to standard or no physical therapy
Authors: Bahar Shahidi PT, DPT, PhD 1 , Connor Richards MASt 2 , Lara Havandjian BS 1,2 , Lissa Taitano PT, DPT 2 , Caitlin Gibson MAT, ATC 2 , Seyed Reza Haghayeh Zavareh 1 , Kamshad Raiszadeh MD 2
Affiliations: (1) UC San Diego Department of Orthopaedic Surgery, La Jolla CA USA (2) SpineZone Medical Fitness, San Diego CA USA
Disclosures and statements: This study was funded in part by the Foundation for Physical Therapy Research Magistro Family Foundation Grant, and NIH R01HD100446 awarded to BS.
KR discloses that he is the Chief Medical Officer of SpineZone Medical Fitness. Due to the de- identified nature of the data utilized in this study, it was determined to be exempt from IRB approval.
Corresponding Author:
Bahar Shahidi PT, DPT, PhD
9500 Gilman Dr. MC0863
La Jolla CA 92093
Bshahidi@health.ucsd.edu
TITLE: Healthcare utilization and cost of care for a multidisciplinary integrated practice unit model of spine rehabilitation compared to standard or no physical therapy
Disclosures and statements: This study was funded in part by the Foundation for Physical Therapy Research Magistro Family Foundation Grant and NIH R01HD100446. One author discloses a role as Chief Medical Officer of a medical fitness clinic. Due to the de-identified nature of the data utilized in this study, it was determined to be exempt from IRB approval.
ABSTRACT:
Objective: To compare healthcare utilization and cost in individuals with spine pain who undergo no physical therapy, standard physical therapy, or physical therapy in an integrated practice unit model.
Design: A retrospective observational study
Methods: De-identified claims data from a single insurance provider was reviewed for individuals under Medicare Advantage with a spine-pain related diagnosis from January 2019- December 2021. Patients were categorized into three cohorts: No physical therapy (NoPT), standard physical therapy (SPT), and physical therapy within an integrated practice unit model (IPUPT) based on their physical therapy history during the data collection period. Number and
percentage of patients reporting claims, number of claims/patient per year, paid amount, and number of RVUs were compared across groups using chi-square or one-way ANOVA with multiple comparisons corrections.
Results: Data from 13,569 patients was included in this study. The number of patients with spine-related inpatient claims was highest in the SPT group (2.8%) compared to the IPUPT (1.5%) and NoPT (1.3%) groups (p=0.004). Outpatient care utilization was driven by radiology
(54.7%) and laboratory (22.1%) claims and was lowest in the IPUPT group (N=1,096; 56.8%) compared to the SPT group (N=1,654; 68.3%) and NoPT group (N=9,150; 99.3%, p<0.001). The SPT group was most costly per person ($2,243.66(11,048.94)) followed by the NoPT ($1,352.01(6,419.2), p<0.001) and the IPUPT ($1,259.88(9,061.23), p<0.001) groups. The greatest contributor to cost was outpatient procedures, averaging $142.39(1,046.26) per person.
Conclusion: An integrated multidisciplinary rehabilitation model may be a cost-effective method of multimodal care in individuals with spine pain.
Key Words: cost effectiveness, spine pain, low back pain, neck pain, physical therapy, economic evaluation
