Table 3.
Follow-up Utilization and Costs, adjusted for baseline utilization and cost
| Total Utilization | Pain Related Utilization | |||||||
|---|---|---|---|---|---|---|---|---|
| Treatment | Control | Treatment | Control | |||||
| Mean | (95% CI) | Mean | (95% CI) | Mean | (95% CI) | Mean | (95% CI) | |
| Encounters with pain-related procedures1 | ||||||||
| Pain-related injections | NA | NA | 0.58 | (0.49, 0.68) | 0.58 | (0.49, 0.69) | ||
| Pain-related surgeries | NA | NA | 0.06 | (0.04, 0.1) | 0.09 | (0.06, 0.14) | ||
| Pain-related imaging | NA | NA | 1.55 | (1.35, 1.77) | 1.72 | (1.51, 1.96) | ||
| Ambulatory visits | ||||||||
| Primary care | 4.91 | (4.59, 5.24) | 4.82 | (4.51, 5.16) | 3.03 | (2.83, 3.26) | 2.89 | (2.69,3.11) |
| Physical therapy3 | 1.86 | (1.48, 2.34) | 1.11 | (0.88, 1.41) | 1.62 | (1.27, 2.07) | 0.9 | (0.7, 1.17) |
| Pain clinic | 0.5 | (0.39, 0.65) | 0.72 | (0.57, 0.92) | 0.46 | (0.36, 0.59) | 0.65 | (0.51,0.83) |
| Other specialty medical care4 | 8.19 | (7.5,8.94) | 8.99 | (8.23, 9.82) | 2.99 | (2.67, 3.34) | 3.17 | (2.83,3.54) |
| Mental health | 0.73 | (0.56, 0.96) | 0.98 | (0.75, 1.29) | 0.04 | (0.02, 0.07) | 0.06 | (0.04,0.09) |
| Complementary and alternative medicine (CAM)5 | 0.21 | (0.11, 0.43) | 0.23 | (0.11, 0.46) | 0.17 | (0.08, 0.35) | 0.22 | (0.11,0.45) |
| ED, Urgent care, and Observation Beds | 1.13 | (0.98, 1.31) | 1.35 | (1.17, 1.55) | 0.57 | (0.48, 0.68) | 0.72 | (0.61,0.85) |
| Hospital ambulatory visits | 0.58 | (0.47, 0.73) | 0.72 | (0.58, 0.9) | 0.25 | (0.19, 0.34) | 0.24 | (0.17,0.32) |
| Same day surgeries | 0.26 | (0.2, 0.33) | 0.25 | (0.2, 0.32) | 0.13 | (0.1, 0.18) | 0.16 | (0.12,0.21) |
| Home health | 1.36 | (0.98, 1.9) | 1.3 | (0.93, 1.82) | 0.62 | (0.43, 0.89) | 0.56 | (0.39,0.81) |
| Total Ambulatory visits | 20.85 | (19.4, 22.41) | 21.59 | (20.07, 23.22) | 10.42 | (9.62, 11.28) | 10.11 | (9.33, 10.96) |
| Telephone or email encounters | 24.04 | (22.57, 25.6) | 23.18 | (21.75, 24.71) | 2.78 | (2.51, 3.08) | 2.81 | (2.53,3.11) |
| Hospital stays 6 | 0.22 | (0.17, 0.28) | 0.28 | (0.22, 0.36) | 0.07 | (0.05, 0.1) | 0.09 | (0.07,0.13) |
| Hospital days6 | 0.86 | (0.59, 1.26) | 1.43 | (0.98, 2.09) | 0.22 | (0.13, 0.39) | 0.48 | (0.28,0.82) |
| Total Pharmacy Dispenses | 50.45 | (48.53, 52.44) | 52.22 | (50.21, 54.3) | NA | NA | ||
| Opioid Pain Dispenses | NA | NA | 13.38 | (12.76, 14.02) | 13.85 | (13.21, 14.52) | ||
| Non-Opioid Pain Dispenses | NA | NA | 11.12 | (10.4, 11.89) | 11.81 | (11.04, 12.63) | ||
| Total Cost | Pain Related Cost | |||||||
| Treatment | Control | Treatment | Control | |||||
| Mean | (95% CI) | Mean | (95% CI) | Mean | (95% CI) | Mean | (95% CI) | |
| Ambulatory visits | ||||||||
| Primary care | $805 | ($749, $860) | $807 | ($751, $863) | $548 | ($509, $588) | $525 | ($486, $565) |
| Physical therapy3 | $245 | ($196, $293) | $145 | ($95, $194) | $202 | ($155, $249) | $122 | ($75, $170) |
| Pain clinic | $130 | ($98, $162) | $150 | ($118, $183) | $123 | ($93, $153) | $141 | ($111, $172) |
| Other specialty medical care4 | $1508 | ($1324, $1693) | $1772 | ($1585, $1959) | $551 | ($477, $626) | $582 | ($507, $657) |
| Mental health | $224 | ($169, $280) | $224 | ($167, $280) | $11 | ($5, $17) | $17 | ($11, $24) |
| Complementary and alternative medicine (CAM)5 | $84 | ($36, $132) | $82 | ($34, $131) | $64 | ($25, $103) | $82 | ($42, $121) |
| ED, Urgent care, and Observation Beds | $1235 | ($893, $1577) | $979 | ($633, $1325) | $992 | ($693, $1292) | $685 | ($381, $988) |
| Hospital ambulatory visits | $827 | ($483, $1172) | $665 | ($316, $1013) | $309 | ($205, $413) | $301 | ($196, $407) |
| Same day surgeries | $417 | ($307, $528) | $431 | ($318, $543) | $200 | ($125, $275) | $264 | ($188, $340) |
| Home health | $355 | ($247, $463) | $318 | ($209, $428) | $159 | ($100, $217) | $131 | ($71, $190) |
| Total Ambulatory visit cost | $5869 | ($5206, $6532) | $5535 | ($4864, $6206) | $3175 | ($2787, $3563) | $2835 | ($2442, $3228) |
| Telephone or email encounters | $392 | ($365, $419) | $395 | ($368, $423) | $51 | ($45, $57) | $53 | ($47, $58) |
| Hospital stays 6 | $4546 | ($1936, $7156) | $7891 | ($5249, $10533) | $1937 | ($−59, $3933) | $3588 | ($1567, $5608) |
| Total Pharmacy Dispenses | $10373 | ($9153, $11592) | $12024 | ($10790, $13258) | NA | NA | ||
| Opioid Dispenses | NA | NA | $1389 | ($1292, $1486) | $1452 | ($1353, $1550) | ||
| NonOpioid Pain Dispenses | NA | NA | $2987 | ($2704, $3271) | $3268 | ($2981, $3555) | ||
| Total Cost | $21372 | ($18114, $24630) | $25648 | ($22350, $28946) | $9395 | ($7216, $11574) | $11343 | ($9137, $13549) |
1.
Pain-related procedures are identified by CPT, HCPCS and ICD-9-PCS or ICD-10-PCS codes. Pain-related surgeries or injections are also included in ambulatory and hospital stays categories (double counted; do not sum).
2.
In-person health care encounters with a pain-related ICD-9-CM or ICD-10-CM diagnostic code
3.
Physical therapy includes Physical Therapy, Occupational Therapy and Physiatry visits
4.
Specialty medical care includes in-person visits to any non-Primary care department that is not included in the table
5.
Complementary and Alternative Medicine includes Acupuncture, Chiropractic, Holistic Health, Naturopathy, and Osteopathy
6.
Pain-related hospitalizations had a primary (or principal) pain-related diagnostic code NA = not applicable