title: 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.
abstract: 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.
  
  
  METHODS
  Electronic medical record (EMR) and insurance claims data.
  
  
  METHODS
  Retrospective analysis of propensity-matched groups.
  
  
  METHODS
  Claims and EMR data were used. Utilization and LBP-related charges over a 1-year period were extracted from claims data.
  
  
  RESULTS
  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.
authors.affiliation: Department of Physical Therapy, College of Health, University of Utah, Salt Lake City, UT.
authors.forename: Julie M
authors.initials: JM
authors.lastname: Fritz
authors.affiliation: Clinical Quality and Outcomes Research, Intermountain Healthcare, Murray, UT.
authors.forename: Gerard P
authors.initials: GP
authors.lastname: Brennan
authors.affiliation: Intermountain Physical Therapy, Intermountain Healthcare, Salt Lake City, UT.
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: Hunter
mesh_terms: D000328:Adult; D015897:Comorbidity; D003952:Diagnostic Imaging / Q000191:economics*; D057286:Electronic Health Records; D005260:Female; D006302:Health Services Research; D006801:Humans; D007345:Insurance Claim Review; D017116:Low Back Pain / Q000175:diagnosis* / Q000534:rehabilitation*; D008297:Male; D008875:Middle Aged; D026741:Physical Therapy Modalities / Q000191:economics*; D011320:Primary Health Care / Q000458:organization & administration*; D012189:Retrospective Studies
keywords: Physical therapy; imaging; low back pain; primary care