Modifications in Major Care Well being Care Utilization after Inclusion of Epidemiologic Knowledge in Lumbar Backbone MR Imaging Experiences 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 studies 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 studies at a tertiary educational medical heart. Knowledge had been collected from July 1, 2012, by June 30, 2014, and retrospective evaluation was accomplished in September 2016. The digital medical file 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 through the examine interval, 375 sufferers had their research ordered by in-network main care suppliers, didn’t have findings aside from degenerative illness, and had at the least one follow-up encounter inside the system inside 1 12 months of index MR imaging. Within the before-and-after examine design, a pre-statement-implementation cohort was in contrast with a post-statement-implementation cohort by utilizing univariate and multivariate statistical fashions to judge therapy 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 examine, inclusion of a easy epidemiologic assertion in lumbar MR imaging studies was related to decreased utilization in high-cost domains of low again ache administration. © RSNA, 2018.
PMID: 29361247 [PubMed – as supplied by publisher]