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Table 2

Unadjusted Health Care Costs and Utilization by Imaging Category

Adherence to Clinical Practice Guidelines That Advise Against Early MRI for Patients without “Red Flags”
Nonadherent (= 336)Adherent (= 1434)p-value
Any utilization of services, %
 MRI100.017.8<.001
 CT5.43.1.048
 Radiograph30.418.1<.001
 Injection40.86.9<.001
 Surgery19.92.5<.001
Number of visits, mean (SD)*
 Chiropractic14.7 (28.1)13.9 (24.2).641
 PT/OT18.4 (19.9)6.8 (13.8)<.001
 Outpatient12.2 (8.0)4.3 (6.1)<.001
Costs, mean (SD)*
 Outpatient services$7,583 (5,147)$2,807 (4,084)<.001
 Inpatient services1,702 (2,445)388 (1,077)<.001
 Non-medical2,425 (3,347)670 (2,062)<.001
 Disability compensation10,442 (10,916)2,775 (6,089)<.001
 Total costs22,151 (17,092)6,640 (11,019)<.001
*Mean number of visits and mean costs include all workers, including nonusers and those with zero costs.
Costs refer to total reimbursed amounts for procedures and visits that occurred within 1 year following injury, inflation adjusted to 2005 equivalents, based on Medical Consumer Price Index.
Nonmedical costs include reimbursement for vocational (return-to-work) assistance or rehabilitation, employability assessments, worker transportation, medical devices, and other costs not included in other cost categories.

Nonadherent group reflects workers who received an MRI within the first 6 weeks of injury. Adherent group reflects workers who received an MRI after the first 6 weeks of injury (= 255) or did not receive an MRI at all (= 1,179).

Values are counts (percentages) and unadjusted means (SD) as indicated. p-values indicate unadjusted comparison using chi-squared or t-tests.

CT, computed tomography (lumbar); MRI, magnetic resonance imaging (lumbar); PT/OT, physical therapy or occupational therapy.

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