Table 2.

Mean 12-Month Costs Based on Guideline Adherence Among 2 467 389 Patients Who Did Not Receive Surgery

Service Use Discouraged by GuidelinesPatients, No. (%) Unadjusted Mean 12-mo Cost per Patient, $ Regression-Adjusted Mean 12-mo Cost per Patient, $
AdherentaNonadherentaAdherentaNonadherentaP ValueAdherentaNonadherentaP Value
Imaging within 30 d of diagnosis
Any imaging1 671 419 (67.7)795 970 (32.3)561 (1803)1204 (2546)<.001566 (1.6)1194 (2.3)<.001
Lumbar computed tomography 2 450 225 (99.3)17 164 (0.7)758 (2064)2300 (4412)<.001758 (1.3)2244 (16.0)<.001
Lumbar magnetic resonance imaging 2 267 341 (91.9)200 048 (8.1)624 (1835)2413 (3597)<.001625 (1.4)2399 (4.6)<.001
Lumbar radiograph1 808 694 (73.3)658 695 (26.7)683 (2027)1004 (2249)<.001687 (1.6)992 (2.6)<.001
Imaging without or before physical therapy
Any imaging1 597 129 (64.7)870 260 (35.3)505 (1623)1253 (2689)<.001509 (1.6)1245 (2.2)<.001
Lumbar computed tomography2 444 400 (99.1)22 989 (0.9)750 (2006)2803 (6199)<.001750 (1.3)2751 (13.8)<.001
Lumbar magnetic resonance imaging2 201 890 (89.2)265 499 (10.8)563 (1693)2472 (3700)<.001565 (1.4)2463 (3.9)<.001
Lumbar radiograph1 751 666 (71.0)715 723 (29.0)649 (1884)1063 (2509)<.001653 (1.6)1052 (2.5)<.001
Imaging within 30 d of diagnosis or imaging without or before physical therapyNeither: 1 611 988 (64.5)Either: 886 025 (35.5)Neither: 964 (5587)Either: 1272 (2713)<.001980 (3.8)1244 (5.1)<.001

aPatients whose treatment was adherent did not receive the services listed; those whose treatment was nonadherent did receive the services.