Table 4. Summary of Health Care Utilization and Costs.
| Care utilization event (during 1-y follow-up unless otherwise noted)a | Participants, No. (%) | ||
|---|---|---|---|
| Usual care (n = 145) | Risk stratified care (n = 145) | Total (n = 290) | |
| Lumbar radiograph | |||
| Any | 39 (26.9) | 37 (25.5) | 76 (26.2) |
| Within 90 d | 26 (17.9) | 25 (17.2) | 51 (17.6) |
| Days to first, median (IQR) | 21 (0-121) | 22 (0-113) | 21 (0-118) |
| Lumbar advanced imaging (MRI or CT)b | |||
| Any | 30 (20.7) | 21 (14.5) | 51 (17.6) |
| Within 90 d | 17 (11.7) | 5 (3.4) | 22 (7.6) |
| Days to first, median (IQR) | 65 (32-190) | 143 (82.5-273) | 131 (39-241) |
| Lumbar injection, therapeutic or diagnostic, joint or epidural | |||
| Any | 8 (5.5) | 6 (4.1) | 14 (4.8) |
| Within 90 d | 3 (2.1) | 2 (1.4) | 5 (1.7) |
| Days to first, median (IQR) | 129 (56-202.5) | 171 (72-266) | 138 (64-252) |
| Intramuscular injection, NSAID or muscle relaxer | 26 (17.9) | 19 (13.1) | 45 (15.5) |
| Within 90 d | 12 (8.3) | 10 (6.9) | 22 (7.6) |
| Days to first, median (IQR) | 82 (0-169) | 144 (5.5-301) | 90 (0-198) |
| Opioids | |||
| Filled a prescription | 29 (20.0) | 32 (22.1) | 61 (21.0) |
| Filled prescription within 90 d | 16 (11.0) | 18 (12.4) | 34 11.7) |
| Unique fills, median (IQR)c | 1 (1-3) | 2 (1-2) | 2 (1-2.5) |
| Total days’ supply, median (IQR)c | 6 (4-23.5) | 7 (4.5-10) | 7 (4-18) |
| Days to first fill, median (IQR)c | 83 (2.5-198.5) | 84 (21.5-179) | 84 (18.5-198.5) |
| Analgesic lidocaine patches | |||
| Any | 33 (22.8) | 46 (31.7) | 79 (27.2) |
| Within 90 d | 20 (13.8) | 29 (20.0) | 49 (16.9) |
| Days to first, median (IQR) | 48 (0-182) | 20 (0-149) | 41 (0-161) |
| Oral muscle relaxants | |||
| Any | 71 (49.0) | 71 (49.0) | 142 (49.0) |
| Within 90 d | 44 (30.3) | 54 (37.2) | 98 (33.8) |
| Days to first, median (IQR) | 11 (0-213) | 0 (0-90) | 3.5 (0-131) |
| Oral analgesics, NSAIDs and acetaminophen | |||
| Any | 117 (80.7) | 110 (75.9) | 237 (81.7) |
| Within 90 d | 72 (49.7) | 74 (51.0) | 146 (50.3) |
| Days to first, median (IQR) | 48 (0-171) | 27.5 (0-137) | 42 (0-146) |
| LBP-related visits | |||
| Mean (SD) | 7.12 (8.76) | 7.74 (8.33) | 7.34 (8.54) |
| Median (IQR) | 3 (1-11) | 5 (2-10) | 4 (2-10) |
| Within 90 d, median (IQR) | 1 (0-1) | 1 (1-3) | 1 (1-2) |
| LBP-related costs, US $ | |||
| Mean (SD) | 1463 (2283) | 1415 (1581) | 1439 (1961) |
| Median (IQR) | 753 (298-1473) | 922 (449-1711) | 850 (319-1626) |
| Total medical costs, US $ | |||
| Mean (SD) | 6951 (10 140) | 8403 (11 535) | 7677 (10 866) |
| Median (IQR) | 3423 (1446-8551) | 4042 (2178-8252) | 3735 (1820-8378) |
Abbreviations: CT, computed tomography; MRI, magnetic resonance imaging; NSAID, nonsteroidal anti-inflammatory drug; LBP, low back pain.
a
All health care utilization variables come from the electronic medical records and claims data in the Military Health System data repository.
b
Only 2 individuals in each group (4 total) received a CT scan.
c
From only those who received a prescription. No participants in either group underwent a lumbar surgical procedure.