Inefficiencies in osteoarthritis and chronic low back pain management
To identify inefficiencies in drug and medical service utilization related to pain management in patients with osteoarthritis and chronic low back pain. This retrospective cohort study applied revised measures of pain management inefficiencies to Humana Medicare members with osteoarthritis and/or ch...
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| Veröffentlicht in: | The American journal of managed care 2013-10, Vol.19 (10), p.816-823 |
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| container_title | The American journal of managed care |
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| creator | Pasquale, Margaret K Dufour, Robert Joshi, Ashish V Reiners, Andrew T Schaaf, David Mardekian, Jack Andrews, George A Patel, Nick C Harnett, James |
| description | To identify inefficiencies in drug and medical service utilization related to pain management in patients with osteoarthritis and chronic low back pain.
This retrospective cohort study applied revised measures of pain management inefficiencies to Humana Medicare members with osteoarthritis and/or chronic low back pain.
Subjects had either 2 or more claims for osteoarthritis on different days or 2 or more claims for low back pain 90 or more days apart, from January 1, 2008, to June 30, 2010, with the first occurrence assigned the index date. Inefficiencies were identified for 365 days postindex.Pain-related healthcare costs postindex were compared between members with and without inefficiencies. A generalized linear model calculated adjusted costs per member controlling for age, sex, and comorbidities.
Most members diagnosed with osteoarthritis, chronic low back pain, or both (N = 68,453) had at least 1 inefficiency measure (n = 37,863) during the postindex period. High per member costs were for repeated surgical procedures ($26,451) and inpatient admissions ($19,372) compared with members without inefficiencies ($781; P < .0001). High total costs (prevalence times per member cost) were for repeated diagnostic testing and excessive office visits. Members with an inefficiency had adjusted pain-related costs 5.42 times higher than those of members without an inefficiency (P |
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This retrospective cohort study applied revised measures of pain management inefficiencies to Humana Medicare members with osteoarthritis and/or chronic low back pain.
Subjects had either 2 or more claims for osteoarthritis on different days or 2 or more claims for low back pain 90 or more days apart, from January 1, 2008, to June 30, 2010, with the first occurrence assigned the index date. Inefficiencies were identified for 365 days postindex.Pain-related healthcare costs postindex were compared between members with and without inefficiencies. A generalized linear model calculated adjusted costs per member controlling for age, sex, and comorbidities.
Most members diagnosed with osteoarthritis, chronic low back pain, or both (N = 68,453) had at least 1 inefficiency measure (n = 37,863) during the postindex period. High per member costs were for repeated surgical procedures ($26,451) and inpatient admissions ($19,372) compared with members without inefficiencies ($781; P < .0001). High total costs (prevalence times per member cost) were for repeated diagnostic testing and excessive office visits. Members with an inefficiency had adjusted pain-related costs 5.42 times higher than those of members without an inefficiency (P <.0001).
Pain management inefficiencies are common and costly among Humana Medicare members with osteoarthritis and/or chronic low back pain. Further work by providers and payers is needed to determine benefits of member identification and early intervention for these inefficiencies.</description><identifier>EISSN: 1936-2692</identifier><identifier>PMID: 24304160</identifier><language>eng</language><publisher>United States</publisher><subject>Adolescent ; Adult ; Chronic Pain - economics ; Chronic Pain - therapy ; Health administration ; Humans ; Insurance Claim Review ; Low Back Pain - economics ; Low Back Pain - therapy ; Middle Aged ; Osteoarthritis - economics ; Osteoarthritis - therapy ; Outcome Assessment (Health Care) ; Pain Management - economics ; Pain Management - standards ; Quality of Health Care ; Retrospective Studies ; Young Adult</subject><ispartof>The American journal of managed care, 2013-10, Vol.19 (10), p.816-823</ispartof><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/24304160$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Pasquale, Margaret K</creatorcontrib><creatorcontrib>Dufour, Robert</creatorcontrib><creatorcontrib>Joshi, Ashish V</creatorcontrib><creatorcontrib>Reiners, Andrew T</creatorcontrib><creatorcontrib>Schaaf, David</creatorcontrib><creatorcontrib>Mardekian, Jack</creatorcontrib><creatorcontrib>Andrews, George A</creatorcontrib><creatorcontrib>Patel, Nick C</creatorcontrib><creatorcontrib>Harnett, James</creatorcontrib><title>Inefficiencies in osteoarthritis and chronic low back pain management</title><title>The American journal of managed care</title><addtitle>Am J Manag Care</addtitle><description>To identify inefficiencies in drug and medical service utilization related to pain management in patients with osteoarthritis and chronic low back pain.
This retrospective cohort study applied revised measures of pain management inefficiencies to Humana Medicare members with osteoarthritis and/or chronic low back pain.
Subjects had either 2 or more claims for osteoarthritis on different days or 2 or more claims for low back pain 90 or more days apart, from January 1, 2008, to June 30, 2010, with the first occurrence assigned the index date. Inefficiencies were identified for 365 days postindex.Pain-related healthcare costs postindex were compared between members with and without inefficiencies. A generalized linear model calculated adjusted costs per member controlling for age, sex, and comorbidities.
Most members diagnosed with osteoarthritis, chronic low back pain, or both (N = 68,453) had at least 1 inefficiency measure (n = 37,863) during the postindex period. High per member costs were for repeated surgical procedures ($26,451) and inpatient admissions ($19,372) compared with members without inefficiencies ($781; P < .0001). High total costs (prevalence times per member cost) were for repeated diagnostic testing and excessive office visits. Members with an inefficiency had adjusted pain-related costs 5.42 times higher than those of members without an inefficiency (P <.0001).
Pain management inefficiencies are common and costly among Humana Medicare members with osteoarthritis and/or chronic low back pain. Further work by providers and payers is needed to determine benefits of member identification and early intervention for these inefficiencies.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Chronic Pain - economics</subject><subject>Chronic Pain - therapy</subject><subject>Health administration</subject><subject>Humans</subject><subject>Insurance Claim Review</subject><subject>Low Back Pain - economics</subject><subject>Low Back Pain - therapy</subject><subject>Middle Aged</subject><subject>Osteoarthritis - economics</subject><subject>Osteoarthritis - therapy</subject><subject>Outcome Assessment (Health Care)</subject><subject>Pain Management - economics</subject><subject>Pain Management - standards</subject><subject>Quality of Health Care</subject><subject>Retrospective Studies</subject><subject>Young Adult</subject><issn>1936-2692</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNo1z81KxDAUBeAgiDOOvoJk6abQ_PQ2Xcow6sCAG12Xm_TGibZpTVrEt3fAcXE4m48D54KtRaOgkNDIFbvO-aMsFRgNV2wltSq1gHLNdvtI3gcXKJ6SeYh8zDONmOZjCnPIHGPH3TGNMTjej9_covvkE57ggBHfaaA437BLj32m23Nv2Nvj7nX7XBxenvbbh0MxSSHmAq3TjQGtOitIKydJV6DQm85UaMBqS3XVKSA0lbFKlVLI2vlaek-mA1Qbdv-3O6Xxa6E8t0PIjvoeI41LboWGygCopjzRuzNd7EBdO6UwYPpp_6-rX410VHY</recordid><startdate>20131001</startdate><enddate>20131001</enddate><creator>Pasquale, Margaret K</creator><creator>Dufour, Robert</creator><creator>Joshi, Ashish V</creator><creator>Reiners, Andrew T</creator><creator>Schaaf, David</creator><creator>Mardekian, Jack</creator><creator>Andrews, George A</creator><creator>Patel, Nick C</creator><creator>Harnett, James</creator><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>7X8</scope></search><sort><creationdate>20131001</creationdate><title>Inefficiencies in osteoarthritis and chronic low back pain management</title><author>Pasquale, Margaret K ; Dufour, Robert ; Joshi, Ashish V ; Reiners, Andrew T ; Schaaf, David ; Mardekian, Jack ; Andrews, George A ; Patel, Nick C ; Harnett, James</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-p211t-abc498643db1e43c2e4563af8d85a86b4be75d36ea858b3302127cf72ffe8d6a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Chronic Pain - economics</topic><topic>Chronic Pain - therapy</topic><topic>Health administration</topic><topic>Humans</topic><topic>Insurance Claim Review</topic><topic>Low Back Pain - economics</topic><topic>Low Back Pain - therapy</topic><topic>Middle Aged</topic><topic>Osteoarthritis - economics</topic><topic>Osteoarthritis - therapy</topic><topic>Outcome Assessment (Health Care)</topic><topic>Pain Management - economics</topic><topic>Pain Management - standards</topic><topic>Quality of Health Care</topic><topic>Retrospective Studies</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Pasquale, Margaret K</creatorcontrib><creatorcontrib>Dufour, Robert</creatorcontrib><creatorcontrib>Joshi, Ashish V</creatorcontrib><creatorcontrib>Reiners, Andrew T</creatorcontrib><creatorcontrib>Schaaf, David</creatorcontrib><creatorcontrib>Mardekian, Jack</creatorcontrib><creatorcontrib>Andrews, George A</creatorcontrib><creatorcontrib>Patel, Nick C</creatorcontrib><creatorcontrib>Harnett, James</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>MEDLINE - Academic</collection><jtitle>The American journal of managed care</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Pasquale, Margaret K</au><au>Dufour, Robert</au><au>Joshi, Ashish V</au><au>Reiners, Andrew T</au><au>Schaaf, David</au><au>Mardekian, Jack</au><au>Andrews, George A</au><au>Patel, Nick C</au><au>Harnett, James</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Inefficiencies in osteoarthritis and chronic low back pain management</atitle><jtitle>The American journal of managed care</jtitle><addtitle>Am J Manag Care</addtitle><date>2013-10-01</date><risdate>2013</risdate><volume>19</volume><issue>10</issue><spage>816</spage><epage>823</epage><pages>816-823</pages><eissn>1936-2692</eissn><abstract>To identify inefficiencies in drug and medical service utilization related to pain management in patients with osteoarthritis and chronic low back pain.
This retrospective cohort study applied revised measures of pain management inefficiencies to Humana Medicare members with osteoarthritis and/or chronic low back pain.
Subjects had either 2 or more claims for osteoarthritis on different days or 2 or more claims for low back pain 90 or more days apart, from January 1, 2008, to June 30, 2010, with the first occurrence assigned the index date. Inefficiencies were identified for 365 days postindex.Pain-related healthcare costs postindex were compared between members with and without inefficiencies. A generalized linear model calculated adjusted costs per member controlling for age, sex, and comorbidities.
Most members diagnosed with osteoarthritis, chronic low back pain, or both (N = 68,453) had at least 1 inefficiency measure (n = 37,863) during the postindex period. High per member costs were for repeated surgical procedures ($26,451) and inpatient admissions ($19,372) compared with members without inefficiencies ($781; P < .0001). High total costs (prevalence times per member cost) were for repeated diagnostic testing and excessive office visits. Members with an inefficiency had adjusted pain-related costs 5.42 times higher than those of members without an inefficiency (P <.0001).
Pain management inefficiencies are common and costly among Humana Medicare members with osteoarthritis and/or chronic low back pain. Further work by providers and payers is needed to determine benefits of member identification and early intervention for these inefficiencies.</abstract><cop>United States</cop><pmid>24304160</pmid><tpages>8</tpages></addata></record> |
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| identifier | EISSN: 1936-2692 |
| ispartof | The American journal of managed care, 2013-10, Vol.19 (10), p.816-823 |
| issn | 1936-2692 |
| language | eng |
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| source | MEDLINE; Free E-Journal (出版社公開部分のみ） |
| subjects | Adolescent Adult Chronic Pain - economics Chronic Pain - therapy Health administration Humans Insurance Claim Review Low Back Pain - economics Low Back Pain - therapy Middle Aged Osteoarthritis - economics Osteoarthritis - therapy Outcome Assessment (Health Care) Pain Management - economics Pain Management - standards Quality of Health Care Retrospective Studies Young Adult |
| title | Inefficiencies in osteoarthritis and chronic low back pain management |
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