Modifications in Main Care Well being Care Utilization after Inclusion of Epidemiologic Information in Lumbar Backbone MR Imaging Stories for Uncomplicated Low Again Ache.
Radiology. 2018 Jan 22;:170722
Authors: Fried JG, Andrew AS, Ring NY, Pastel DA
Objective To find out whether or not inclusion of an epidemiologic assertion in radiology experiences of lumbar magnetic resonance (MR) imaging influences downstream well being care utilization within the main care inhabitants. Supplies and Strategies Starting July 1, 2013, a validated epidemiologic assertion relating to prevalence of frequent findings in asymptomatic sufferers was included in all lumbar MR imaging experiences at a tertiary educational medical heart. Information had been collected from July 1, 2012, via June 30, 2014, and retrospective evaluation was accomplished in September 2016. The digital medical document was reviewed to seize well being care utilization charges in sufferers for 1 12 months after index MR imaging. Of 4527 eligible grownup sufferers with low again ache referred for lumbar backbone MR imaging throughout the research interval, 375 sufferers had their research ordered by in-network main care suppliers, didn’t have findings apart from degenerative illness, and had at the very least one follow-up encounter inside the system inside 1 12 months of index MR imaging. Within the before-and-after research design, a pre-statement-implementation cohort was in contrast with a post-statement-implementation cohort through the use of univariate and multivariate statistical fashions to guage remedy utilization charges in these teams. Outcomes Sufferers within the assertion group had been 12% much less more likely to be referred to a backbone specialist (137 of 187 [73%] vs 159 of 188 [85%]; P = .007) and had been 7% much less more likely to endure repeat imaging (seven of 187 [4%] vs 20 of 188 [11%]; P = .01) in contrast with sufferers within the nonstatement group. The intervention was not related to any change in narcotic prescription (53 of 188 [28%] vs 54 of 187 [29%]; P = .88) or with the speed of low again surgical procedure (24 of 188 [13%] vs 16 of 187 [9%]; P = .19). Conclusion On this research, inclusion of a easy epidemiologic assertion in lumbar MR imaging experiences was related to decreased utilization in high-cost domains of low again ache administration. © RSNA, 2018.
PMID: 29361247 [PubMed – as supplied by publisher]