Effect on healthcare utilization and costs of spinal manual therapy for acute low back pain in routine care: A propensity score matched cohort study

dc.bibliographicCitation.firstPagee0177255
dc.bibliographicCitation.issue5
dc.bibliographicCitation.journalTitlePLOS ONEeng
dc.bibliographicCitation.volume12
dc.contributor.authorWalker, Jochen
dc.contributor.authorMertens, Ulf Kai
dc.contributor.authorSchmidt, Carsten Oliver
dc.contributor.authorChenot, Jean-François
dc.date.accessioned2023-03-01T05:37:49Z
dc.date.available2023-03-01T05:37:49Z
dc.date.issued2017
dc.description.abstractSpinal manual therapy (SMT) is a popular treatment option for low back pain (LBP). The aim of our analysis was to evaluate the effects of manual therapy delivered by general practitioners and ambulatory orthopedic surgeons in routine care on follow up consultations, sick leave, health service utilization and costs for acute LBP compared to matched patients not receiving manual therapy. This is a propensity score matched cohort study based on health claims data. We identified a total of 113.652 adult patients with acute LBP and no coded red flags of whom 21.021 (18%) received SMT by physicians. In the final analysis 17.965 patients in each group could be matched. Balance on patients' coded characteristics, comorbidity and prior health service utilization was achieved. The provision of SMT for acute LBP had no relevant impact on follow up visits and days of sick leave for LBP in the index billing period and the following year. SMT was associated with a higher proportion of imaging studies for LBP (30.6% vs. 23%, SMD: 0.164 [95% CI 0.143-0.185]). SMT did not lead to meaningful savings by replacing other health services for LBP. SMT for acute non-specific LBP in routine care was not clinically meaningful effective to reduce sick leave and reconsultation rates compared to no SMT and did not lead to meaningful savings by replacing other health services from the perspective of health insurance. This does not imply that SMT is ineffective but might reflect a problem with selection of suitable patients and the quality and quantity of SMT in routine care. National Manual Medicine societies should state clearly that imaging is not routinely needed prior to SMT in patients with low suspicion of presence of red flags and monitor the quality of provided services.eng
dc.description.versionpublishedVersioneng
dc.identifier.urihttps://oa.tib.eu/renate/handle/123456789/11594
dc.identifier.urihttp://dx.doi.org/10.34657/10627
dc.language.isoeng
dc.publisherSan Francisco, California, US : PLOS
dc.relation.doihttps://doi.org/10.1371/journal.pone.0177255
dc.relation.essn1932-6203
dc.rights.licenseCC BY 4.0 Unported
dc.rights.urihttps://creativecommons.org/licenses/by/4.0
dc.subject.ddc500
dc.subject.ddc610
dc.subject.otheracupunctureeng
dc.subject.otheradulteng
dc.subject.othercohort analysiseng
dc.subject.othercomorbidityeng
dc.subject.othercontrolled studyeng
dc.subject.othercost controleng
dc.subject.otherfemaleeng
dc.subject.otherfollow upeng
dc.subject.otherhealth care costeng
dc.subject.otherhealth care utilizationeng
dc.subject.otherhealth insuranceeng
dc.subject.otherhumaneng
dc.subject.otherlow back paineng
dc.subject.othermajor clinical studyeng
dc.subject.othermaleeng
dc.subject.othermedical leaveeng
dc.subject.otherphysiotherapyeng
dc.subject.otherpropensity scoreeng
dc.subject.otherspine manipulationeng
dc.subject.othertherapy effecteng
dc.subject.otheradolescenteng
dc.subject.othercase control studyeng
dc.subject.othereconomicseng
dc.subject.otherlow back paineng
dc.subject.othermiddle agedeng
dc.subject.othermultimodality cancer therapyeng
dc.subject.otherpatient attitudeeng
dc.subject.otherprocedureseng
dc.subject.otherspine manipulationeng
dc.subject.otheryoung adulteng
dc.titleEffect on healthcare utilization and costs of spinal manual therapy for acute low back pain in routine care: A propensity score matched cohort studyeng
dc.typeArticleeng
dc.typeTexteng
tib.accessRightsopenAccess
wgl.contributorLIKAT
wgl.subjectMedizin, Gesundheitger
wgl.typeZeitschriftenartikelger
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