Table 2.
Mean 12-Month Costs Based on Guideline Adherence Among 2 467 389 Patients Who Did Not Receive Surgery
Service Use Discouraged by Guidelines Patients, No. (%) Unadjusted Mean 12-mo Cost per Patient, $ Regression-Adjusted Mean 12-mo Cost per Patient, $ Adherenta Nonadherenta Adherenta Nonadherenta P Value Adherenta Nonadherenta P Value Imaging within 30 d of diagnosis Any imaging 1 671 419 (67.7) 795 970 (32.3) 561 (1803) 1204 (2546) <.001 566 (1.6) 1194 (2.3) <.001 Lumbar computed tomography 2 450 225 (99.3) 17 164 (0.7) 758 (2064) 2300 (4412) <.001 758 (1.3) 2244 (16.0) <.001 Lumbar magnetic resonance imaging 2 267 341 (91.9) 200 048 (8.1) 624 (1835) 2413 (3597) <.001 625 (1.4) 2399 (4.6) <.001 Lumbar radiograph 1 808 694 (73.3) 658 695 (26.7) 683 (2027) 1004 (2249) <.001 687 (1.6) 992 (2.6) <.001 Imaging without or before physical therapy Any imaging 1 597 129 (64.7) 870 260 (35.3) 505 (1623) 1253 (2689) <.001 509 (1.6) 1245 (2.2) <.001 Lumbar computed tomography 2 444 400 (99.1) 22 989 (0.9) 750 (2006) 2803 (6199) <.001 750 (1.3) 2751 (13.8) <.001 Lumbar magnetic resonance imaging 2 201 890 (89.2) 265 499 (10.8) 563 (1693) 2472 (3700) <.001 565 (1.4) 2463 (3.9) <.001 Lumbar radiograph 1 751 666 (71.0) 715 723 (29.0) 649 (1884) 1063 (2509) <.001 653 (1.6) 1052 (2.5) <.001 Imaging within 30 d of diagnosis or imaging without or before physical therapy Neither: 1 611 988 (64.5) Either: 886 025 (35.5) Neither: 964 (5587) Either: 1272 (2713) <.001 980 (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.