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Table 3

Adjusted Health Care Costs and Utilization: Results from Propensity Score-Adjusted Regression Analyses

Nonadherent versus Adherent to Clinical Practice Guidelines That Advise against Early MRI for Patients without “Red Flags”
Any utilization of servicesRR (95% CI)
 CT0.40 (0.18, 0.92)
 Radiograph1.04 (0.81, 1.34)
 Injection1.93 (1.43, 2.62)
 Surgery2.16 (1.28, 3.66)
Number of office visitsIRR (95% CI)
 Chiropractic0.82 (0.69, 0.97)
 PT/OT1.54 (1.33, 1.80)
 Outpatient1.52 (1.30, 1.77)
Costs*CR (95% CI)
 Outpatient services1.52 (1.33, 1.70)
 Inpatient services3.10 (1.72, 4.47)
 Non-medical1.87 (1.34, 2.39)
 Disability compensation1.63 (1.34, 1.92)
 Total costs1.62 (1.38, 1.86)
*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.

Ratios compare workers whose imaging experience was not adherent to clinical practice guidelines (received early MRI) to workers with imaging adherent to guidelines (workers who received an MRI after the first 6 weeks of injury or did not receive an MRI at all).

CR, cost ratio; CT, computed tomography; IRR, incidence rate ratio; MRI, magnetic resonance imaging; PT/OT, physical therapy or occupational therapy; RR, relative risk.

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