Multidisciplinary, evidence-based process for hospital-based standardized spine care results in minimized LBP and treatment costs

July 29, 2011 — The use of a patient-centered, multidisciplinary Spine Care Pathway (SCP) helped to minimize lower back pain (LBP) and the associated treatment costs, according to a recent study, “A Hospital-Based Standardized Spine Care Pathway: Report of a Multidisciplinary, Evidence-Based Process,” published in the Journal of Manipulative and Physiological Therapeutics, February 2011, Vol. 34, Issue 2, Pages 98-106.

Using the National Center for Quality Assurance (NCQA) Back Pain Recognition Program (BPRP) as its framework, the SCP provided patients with the five care options cited as the most effective in the back pain literature: spinal manipulation, extension and flexion directional preference exercises, core stabilization exercises, and mechanical traction.

“Lower back pain is a common condition affecting an estimated 90 percent of the population at some time,” says Ian C. Paskowski, DC, lead author and medical director, Medical Back Pain Program at Jordan Hospital, Plymouth, Mass., the site from which this study’s data was derived. “Current methods of relieving LBP are often uncoordinated, inefficient and expensive. However, our team of researchers was the first to implement an evidence-based, standardized SCP, which aligned individual patients with the appropriate conservative care option. As predicted, the results were improved patient health and satisfaction rates, with decreased costs.”

The LBP program at Jordan Hospital, managed chiefly by chiropractors, treated 518 patients in the first six months of the program, using a two-tiered clinical management approach.  Of the total patient population, 402 were exclusively cared for by DCs who achieved successful treatment outcomes in an average of just 5.2 visits at the extremely low cost of only $302 per case, while maintaining a patient satisfaction rate above 95 percent.  Self-reported pain and disability scores were reduced by about 70% over the course of just a few weeks.

Primary Care Physicians (PCPs) have traditionally been the providers to initially see LBP patients. “We have demonstrated that when this spine care pathway is offered to PCPs, they will utilize these evidence-based guidelines and chiropractic services” says Paskowski. “I largely credit our Doctors of Chiropractic for achieving these excellent clinical outcomes and attaining such high patient satisfaction rates. Their dedication to individual patient needs and a patient-centered approach aligns flawlessly with the medical home model and yields remarkable results.  We anticipate that this SCP will become the globalized framework for uniformity and consistency in healthcare for LBP management, and that chiropractors will become the non-surgical spine care experts in the health care system.”

Source: Foundation for Chiropractic Progress, www.f4cp.org