{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T04:15:11Z","timestamp":1788322511699,"version":"build-2803163510"},"reference-count":26,"publisher":"Oxford University Press (OUP)","issue":"9","funder":[{"name":"United States Department of Veterans Affairs Health Services Research and Development Service","award":["1IK2HX003053"],"award-info":[{"award-number":["1IK2HX003053"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,8,31]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Importance<\/jats:title>\n                    <jats:p>Emergency department (ED) care for musculoskeletal pain is associated with higher healthcare utilization compared to other entry points into the healthcare system. Emergency department physical therapists are associated with decreased healthcare utilization in the ED; however, long-term healthcare utilization after the ED visit is understudied.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>The objective was to study the association between an ED physical therapist visit and 1-year physical therapist visit utilization and total musculoskeletal healthcare utilization.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>This study used a retrospective cohort design.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting and Participants<\/jats:title>\n                    <jats:p>This study included Veterans presenting to a single Veterans Health Administration ED with a primary diagnosis of musculoskeletal pain.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Intervention(s) or Exposure(s)<\/jats:title>\n                    <jats:p>Veterans who saw an ED physical therapist (EDPT group) from October 2022 to September 2023 were randomly sampled and age, sex, and ICD-10 ED primary diagnosis code matched to veterans without an EDPT visit.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main Outcome(s) and Measure(s)<\/jats:title>\n                    <jats:p>The primary outcome was 1-year physical therapist visits after initial ED visit. Secondary outcomes included: 1-year utilization of physician specialty care visits, advanced imaging (magnetic resonance imaging and computed tomography), high-risk prescription (opioids, benzodiazepines, and skeletal muscle relaxants), and ED return visit for the initial ED diagnosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Physical therapist visits did not differ between groups (mean [SD]: EDPT\u2009=\u20092.89 [5.02] vs matched control\u2009=\u20092.69 [5.15]). Emergency department physical therapist was associated with lower rates of physician specialty visits (rate ratio: 0.52 [0.33 to 0.81]) and lower odds of specialist referral (odds ratio: 0.32 [0.16 to 0.63]) and advanced imaging (odds ratio 0.41 [0.21 to 0.84]). Emergency department physical therapist was not significantly associated with high-risk medication prescriptions or return visits to the ED.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions and Relevance<\/jats:title>\n                    <jats:p>Emergency department physical therapist was significantly associated with reduced specialist services and advanced imaging during the year after the initial ED visit. These findings support physical therapists in the ED as a strategy that may reduce unnecessary healthcare utilization for Veterans with musculoskeletal pain.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ptj\/pzag079","type":"journal-article","created":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T11:57:22Z","timestamp":1785412642000},"source":"Crossref","is-referenced-by-count":0,"title":["One-year health care utilization following physical therapist evaluation in a veterans affairs emergency department"],"prefix":"10.1093","volume":"106","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-1835-5689","authenticated-orcid":false,"given":"Emily E","family":"Stone","sequence":"first","affiliation":[{"name":"Geriatric Research Education and Clinical Center (GRECC), Eastern Colorado VA Health Care System , Aurora, CO 80045 ,","place":["United States"]},{"name":"Department of Physical Medicine and Rehabilitation, University of Colorado , Aurora, CO 80045 ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vanessa L","family":"Richardson","sequence":"additional","affiliation":[{"name":"Geriatric Research Education and Clinical Center (GRECC), Eastern Colorado VA Health Care System , Aurora, CO 80045 ,","place":["United States"]},{"name":"Department of Biostatistics and Informatics, Colorado School of Public Heath, University of Colorado Anschutz Medical Campus , Aurora, CO 80045 ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6618-1316","authenticated-orcid":false,"given":"Debashis","family":"Ghosh","sequence":"additional","affiliation":[{"name":"Department of Biostatistics and Informatics, Colorado School of Public Heath, University of Colorado Anschutz Medical Campus , Aurora, CO 80045 ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liza M","family":"Creel","sequence":"additional","affiliation":[{"name":"Division of Health Care Policy and Research, Department of Medicine, University of Colorado Anschutz Medical Campus , Denver, CO 80045 ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shane M","family":"O\u2019Malley","sequence":"additional","affiliation":[{"name":"Physical Medicine and Rehabilitation, Rocky Mountain Regional VA Medical Center , Aurora, CO 80045 ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8118-378X","authenticated-orcid":false,"given":"Jennifer E","family":"Stevens-Lapsley","sequence":"additional","affiliation":[{"name":"Geriatric Research Education and Clinical Center (GRECC), Eastern Colorado VA Health Care System , Aurora, CO 80045 ,","place":["United States"]},{"name":"Department of Physical Medicine and Rehabilitation, University of Colorado , Aurora, CO 80045 ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lauren M","family":"Abbate","sequence":"additional","affiliation":[{"name":"Geriatric Research Education and Clinical Center (GRECC), Eastern Colorado VA Health Care System , Aurora, CO 80045 ,","place":["United States"]},{"name":"Department of Emergency Medicine, University of Colorado School of Medicine , Aurora, CO 80045 ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,7,31]]},"reference":[{"key":"2026090123312459700_ref1","volume-title":"Most Frequent Reasons for Emergency Department Visits","author":"Weiss","year":"2018"},{"issue":"4","key":"2026090123312459700_ref2","doi-asserted-by":"publisher","first-page":"e0231476","DOI":"10.1371\/journal.pone.0231476","article-title":"Dedicated emergency department physical therapy is associated with reduced imaging, opioid administration, and length of stay: a prospective observational study","volume":"15","author":"Pugh","year":"2020","journal-title":"PLoS One"},{"key":"2026090123312459700_ref3","doi-asserted-by":"publisher","first-page":"17","DOI":"10.1016\/j.ajem.2021.02.038","article-title":"Top 10 presenting diagnoses of homeless veterans seeking care at emergency departments","volume":"45","author":"Tsai","year":"2021","journal-title":"Am J Emerg Med"},{"issue":"6","key":"2026090123312459700_ref4","doi-asserted-by":"publisher","first-page":"648","DOI":"10.1016\/j.jemermed.2016.05.052","article-title":"Safely managing acute osteoarthritis in the emergency department: an evidence-based review","volume":"51","author":"Young","year":"2016","journal-title":"J Emerg Med"},{"issue":"5","key":"2026090123312459700_ref5","doi-asserted-by":"publisher","first-page":"e158","DOI":"10.1097\/BOT.0000000000001430","article-title":"Orthopaedic trauma association musculoskeletal pain task F. Clinical practice guidelines for pain management in acute musculoskeletal injury","volume":"33","author":"Hsu","year":"2019","journal-title":"J Orthop Trauma"},{"issue":"8","key":"2026090123312459700_ref6","doi-asserted-by":"publisher","first-page":"e2014313","DOI":"10.1001\/jamanetworkopen.2020.14313","article-title":"Appointment wait times for specialty care in Veterans Health Administration facilities vs community medical centers","volume":"3","author":"Griffith","year":"2020","journal-title":"JAMA Netw Open"},{"issue":"7","key":"2026090123312459700_ref7","doi-asserted-by":"publisher","first-page":"1324","DOI":"10.1016\/j.apmr.2018.11.025","article-title":"The effect of timing of physical therapy for acute low back pain on health services utilization: a systematic review","volume":"100","author":"Arnold","year":"2019","journal-title":"Arch Phys Med Rehabil"},{"issue":"5","key":"2026090123312459700_ref8","doi-asserted-by":"publisher","first-page":"808","DOI":"10.1016\/j.apmr.2013.01.008","article-title":"Initial management decisions after a new consultation for low back pain: implications of the usage of physical therapy for subsequent health care costs and utilization","volume":"94","author":"Fritz","year":"2013","journal-title":"Arch Phys Med Rehabil"},{"issue":"3","key":"2026090123312459700_ref9","doi-asserted-by":"publisher","first-page":"333","DOI":"10.2519\/josptopen.2025.0135","article-title":"The effect of early physical therapy intervention on case duration and physical therapy visits in acute work-related musculoskeletal injuries across body regions: a retrospective cohort study","volume":"3","author":"Morgan","year":"2025","journal-title":"JOSPT Open"},{"issue":"2","key":"2026090123312459700_ref10","doi-asserted-by":"publisher","first-page":"56","DOI":"10.2519\/jospt.2016.6138","article-title":"Timing of physical therapy initiation for nonsurgical management of musculoskeletal disorders and effects on patient outcomes: a systematic review","volume":"46","author":"Ojha","year":"2016","journal-title":"J Orthop Sports Phys Ther"},{"issue":"4","key":"2026090123312459700_ref11","doi-asserted-by":"publisher","first-page":"424","DOI":"10.1111\/acem.14707","article-title":"Integrating physical therapy into an emergency department: a clinical pilot program","volume":"30","author":"Abbate","year":"2023","journal-title":"Acad Emerg Med"},{"issue":"3","key":"2026090123312459700_ref12","doi-asserted-by":"publisher","DOI":"10.1093\/ptj\/pzaa219","article-title":"A prospective observational study of emergency department-initiated physical therapy for acute low back pain","volume":"101","author":"Kim","year":"2021","journal-title":"Phys Ther"},{"issue":"8","key":"2026090123312459700_ref13","doi-asserted-by":"publisher","first-page":"848","DOI":"10.1111\/acem.14237","article-title":"Direct-access physiotherapy to help manage patients with musculoskeletal disorders in an emergency department: results of a randomized controlled trial","volume":"28","author":"Gagnon","year":"2021","journal-title":"Acad Emerg Med"},{"issue":"2","key":"2026090123312459700_ref14","doi-asserted-by":"publisher","first-page":"128","DOI":"10.1016\/j.annemergmed.2011.09.012","article-title":"One-week and 3-month outcomes after an emergency department visit for undifferentiated musculoskeletal low back pain","volume":"59","author":"Friedman","year":"2012","journal-title":"Ann Emerg Med"},{"issue":"3","key":"2026090123312459700_ref15","doi-asserted-by":"publisher","first-page":"330","DOI":"10.2522\/ptj.20090290","article-title":"Utilization and clinical outcomes of outpatient physical therapy for medicare beneficiaries with musculoskeletal conditions","volume":"91","author":"Fritz","year":"2011","journal-title":"Phys Ther"},{"issue":"3","key":"2026090123312459700_ref16","doi-asserted-by":"publisher","first-page":"e233404","DOI":"10.1001\/jamanetworkopen.2023.3404","article-title":"Evaluation of the emergency severity index in US emergency departments for the rate of mistriage","volume":"6","author":"Sax","year":"2023","journal-title":"JAMA Netw Open"},{"issue":"1","key":"2026090123312459700_ref17","doi-asserted-by":"publisher","first-page":"648","DOI":"10.1186\/s12913-018-3470-6","article-title":"Prediction of healthcare utilization following an episode of physical therapy for musculoskeletal pain","volume":"18","author":"Lentz","year":"2018","journal-title":"BMC Health Serv Res"},{"key":"2026090123312459700_ref18","doi-asserted-by":"publisher","first-page":"825","DOI":"10.2147\/CLEP.S323903","article-title":"Trajectories of musculoskeletal healthcare utilization of people with chronic musculoskeletal pain - a population-based cohort study","volume":"Volume 13","author":"Mose","year":"2021","journal-title":"Clin Epidemiol"},{"issue":"1","key":"2026090123312459700_ref19","doi-asserted-by":"publisher","first-page":"13","DOI":"10.1093\/biomet\/73.1.13","article-title":"Longitudinal data analysis using generalized linear models","volume":"73","author":"Liang","year":"1986","journal-title":"Biometrika."},{"key":"2026090123312459700_ref20","doi-asserted-by":"publisher","DOI":"10.1093\/oso\/9780198524847.001.0001","volume-title":"Analysis of Longitudinal Data","author":"Diggle","year":"2002","edition":"2"},{"issue":"2","key":"2026090123312459700_ref21","doi-asserted-by":"publisher","first-page":"202","DOI":"10.2522\/ptj.20150060","article-title":"Utilization and payments of office-based physical rehabilitation services among individuals with commercial insurance in New York state","volume":"96","author":"Liu","year":"2016","journal-title":"Phys Ther"},{"issue":"7","key":"2026090123312459700_ref22","doi-asserted-by":"publisher","first-page":"1018","DOI":"10.2522\/ptj.20100343","article-title":"Determinants of utilization and expenditures for episodes of ambulatory physical therapy among adults","volume":"91","author":"Machlin","year":"2011","journal-title":"Phys Ther"},{"issue":"1","key":"2026090123312459700_ref23","doi-asserted-by":"publisher","first-page":"84","DOI":"10.1007\/s11606-023-08376-0","article-title":"Changes in patient-reported outcomes associated with receiving whole health in the Veteran Health Administration (VHA)'s National Demonstration Project","volume":"39","author":"Bokhour","year":"2024","journal-title":"J Gen Intern Med"},{"issue":"5","key":"2026090123312459700_ref24","doi-asserted-by":"publisher","first-page":"1009","DOI":"10.1111\/jgs.15276","article-title":"Should structured exercise be promoted as a model of care? Dissemination of the Department of Veterans Affairs Gerofit Program","volume":"66","author":"Morey","year":"2018","journal-title":"J Am Geriatr Soc"},{"issue":"10","key":"2026090123312459700_ref25","doi-asserted-by":"publisher","first-page":"1046","DOI":"10.1093\/ptj\/85.10.1046","article-title":"Longitudinal continuity of care is associated with high patient satisfaction with physical therapy","volume":"85","author":"Beattie","year":"2005","journal-title":"Phys Ther"},{"issue":"12","key":"2026090123312459700_ref26","doi-asserted-by":"publisher","first-page":"990","DOI":"10.1093\/ptj\/pzy103","article-title":"Associations between physical therapy continuity of care and health care utilization and costs in patients with low back pain: a retrospective cohort study","volume":"98","author":"Magel","year":"2018","journal-title":"Phys Ther"}],"container-title":["Physical Therapy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ptj\/advance-article-pdf\/doi\/10.1093\/ptj\/pzag079\/70410212\/pzag079.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ptj\/article-pdf\/106\/9\/pzag079\/70410212\/pzag079.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ptj\/article-pdf\/106\/9\/pzag079\/70410212\/pzag079.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T03:31:53Z","timestamp":1788319913000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ptj\/article\/doi\/10.1093\/ptj\/pzag079\/8748306"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,31]]},"references-count":26,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2026,8,31]]}},"URL":"https:\/\/doi.org\/10.1093\/ptj\/pzag079","relation":{},"ISSN":["0031-9023","1538-6724"],"issn-type":[{"value":"0031-9023","type":"print"},{"value":"1538-6724","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,9]]},"published":{"date-parts":[[2026,7,31]]},"article-number":"pzag079"}}