Do the Number of Visits and the Cost of Musculoskeletal Care Improve Outcomes? More May Not Be Better.
J Orthop Sports Phys Ther
; 50(11): 642-648, 2020 11.
Article
en En
| MEDLINE
| ID: mdl-33131393
ABSTRACT
OBJECTIVES:
To determine the relationship between health care use and the magnitude of change in patient-reported outcomes in individuals who received treatment for subacromial pain syndrome. The secondary objective was to determine the value of care, as measured by change in pain and disability per dollar spent.DESIGN:
Secondary analysis of a randomized clinical trial that investigated the effects of nonsurgical care for subacromial pain syndrome.METHODS:
Two groups of treatment responders were created, based on 1-year change in Shoulder Pain and Disability Index (SPADI) score (high, 46.83 points; low, 8.21 points). Regression analysis was performed to determine the association between health care use and 1-year change in SPADI score. Baseline SPADI score was used as a covariate in the regression analysis. Value was measured by comparing health care visits and costs expended per SPADI 1-point change between responder groups.RESULTS:
Ninety-eight patients were included; 38 were classified as high responders (mean 1-year SPADI change score, 46.83 points) and 60 were classified as low responders (1-year SPADI change score, 8.21 points). Neither unadjusted medical visits (5.89; 95% confidence interval [CI] 4.35, 7.44 versus 6.30; 95% CI 5.14, 7.46) nor medical costs ($1404.86; 95% CI $1109.34, $1779.09 versus $1679.26; 95% CI $1391.54, $2026.48) were significantly different between high and low responders, respectively.CONCLUSION:
Neither the number of visits nor the financial cost of nonsurgical shoulder- related care was associated with improvement in shoulder pain and disability at 1 year. J Orthop Sports Phys Ther 2020;50(11)642-648. doi10.2519/jospt.2020.9440.Palabras clave
Texto completo:
1
Bases de datos:
MEDLINE
Métodos Terapéuticos y Terapias MTCI:
Terapias_manuales
/
Masoterapia
Asunto principal:
Visita a Consultorio Médico
/
Costos de la Atención en Salud
/
Síndrome de Abducción Dolorosa del Hombro
/
Atención a la Salud
/
Medición de Resultados Informados por el Paciente
Tipo de estudio:
Clinical_trials
/
Health_economic_evaluation
Idioma:
En
Revista:
J Orthop Sports Phys Ther
Año:
2020
Tipo del documento:
Article