Physical Therapy or Advanced Imaging as First Management Strategy Following a New Consultation for Low Back Pain in Primary Care: Associations with Future Health Care Utilization and Charges

OBJECTIVE: Compare health care utilization and charges for low-back-pain (LBP) patients receiving advanced imaging or physical therapy as a first management strategy following a new primary care consultation. DATA SOURCE: Electronic medical record (EMR) and insurance claims data. STUDY DESIGN: Retrospective analysis of propensity-matched groups. DATA COLLECTION/EXTRACTION: Claims and EMR data were used. Utilization and LBP-related charges over a 1-year period were extracted from claims data. PRINCIPAL FINDINGS: In the propensity-matched sample (n = 406), advanced imaging recipients had higher odds of all utilization outcomes. Charges were higher with advanced imaging by an average $4,793 (95 percent CI: $3,676, $5,910). CONCLUSIONS: For patients with LBP whom newly consulted primary care referred for additional management, advanced imaging as a first management was associated with higher health care utilization and charges than physical therapy.