{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"institution":[{"name":"medRxiv"}],"indexed":{"date-parts":[[2026,1,16]],"date-time":"2026-01-16T13:42:06Z","timestamp":1768570926692,"version":"3.49.0"},"posted":{"date-parts":[[2025,6,16]]},"group-title":"Rehabilitation Medicine and Physical Therapy","reference-count":27,"publisher":"openRxiv","license":[{"start":{"date-parts":[[2025,6,16]],"date-time":"2025-06-16T00:00:00Z","timestamp":1750032000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"accepted":{"date-parts":[[2025,6,16]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                <jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>To compare healthcare utilization and cost in individuals with spine pain who undergo no physical therapy, standard physical therapy, or physical therapy in an integrated practice unit model.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Design<\/jats:title>\n                  <jats:p>A cost-effectiveness analysis<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Setting<\/jats:title>\n                  <jats:p>Multi-site outpatient physical therapy clinics within a single metropolitan region<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Participants<\/jats:title>\n                  <jats:p>Individuals with de-identified claims data from a single insurance provider under Medicare Advantage with a spine-pain related diagnosis from January 2019-December 2021.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Interventions<\/jats:title>\n                  <jats:p>Patients were categorized into three cohorts: No physical therapy (NoPT), standard physical therapy (SPT), and physical therapy within an integrated practice unit model (IPUPT) based on their physical therapy history during the data collection period.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Main Outcome Measures<\/jats:title>\n                  <jats:p>Number and percentage of patients reporting claims, number of claims\/patient per year, paid amount, and number of RVUs were compared across groups using chi-square or one-way ANOVA with multiple comparisons corrections.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Data from 13,569 patients was included in this study. The number of patients with spine-related inpatient claims was highest in the SPT group (2.8%) compared to the IPUPT (1.5%) and NoPT (1.3%) groups (p=0.004). Outpatient care utilization was driven by radiology (54.7%) and laboratory (22.1%) claims and was lowest in the IPUPT group (N=1,096; 56.8%) compared to the SPT group (N=1,654; 68.3%) and NoPT group (N=9,150; 99.3%, p&lt;0.001). The SPT group was most costly per person ($2,243.66(11,048.94)) followed by the NoPT ($1,352.01(6,419.2), p&lt;0.001) and the IPUPT ($1,259.88(9,061.23), p&lt;0.001) groups. The greatest contributor to cost was outpatient procedures, averaging $142.39(1,046.26) per person.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>An integrated multidisciplinary rehabilitation model may be a cost-effective method of multimodal care in individuals with spine pain.<\/jats:p>\n                <\/jats:sec>","DOI":"10.1101\/2025.06.10.25327236","type":"posted-content","created":{"date-parts":[[2025,6,16]],"date-time":"2025-06-16T13:45:22Z","timestamp":1750081522000},"source":"Crossref","is-referenced-by-count":0,"title":["Healthcare utilization and cost of care for a multidisciplinary integrated practice unit model of spine rehabilitation compared to standard or no physical therapy"],"prefix":"10.64898","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7532-6940","authenticated-orcid":false,"given":"Bahar","family":"Shahidi","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Connor","family":"Richards","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lissa","family":"Taitano","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Armin","family":"Zavareh","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kamshad","family":"Raiszadeh","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"54368","reference":[{"key":"2025061802001081000_2025.06.10.25327236v1.1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2013.13805"},{"issue":"11","key":"2025061802001081000_2025.06.10.25327236v1.2","doi-asserted-by":"crossref","first-page":"E668","DOI":"10.1097\/BRS.0b013e318241e5de","article-title":"The burden of chronic low back pain: clinical comorbidities, treatment patterns, and health care costs in usual care settings","volume":"37","year":"2012","journal-title":"Spine (Phila Pa 1976)"},{"key":"2025061802001081000_2025.06.10.25327236v1.3","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2013-204428"},{"issue":"5","key":"2025061802001081000_2025.06.10.25327236v1.4","doi-asserted-by":"crossref","first-page":"285","DOI":"10.1097\/BRS.0000000000001729","article-title":"Cost-Effectiveness of Primary Care Management With or Without Early Physical Therapy for Acute Low Back Pain: Economic Evaluation of a Randomized Clinical Trial","volume":"42","year":"2017","journal-title":"Spine (Phila Pa 1976)"},{"issue":"25","key":"2025061802001081000_2025.06.10.25327236v1.5","doi-asserted-by":"crossref","first-page":"2114","DOI":"10.1097\/BRS.0b013e31825d32f5","article-title":"Primary care referral of patients with low back pain to physical therapy: impact on future health care utilization and costs","volume":"37","year":"2012","journal-title":"Spine (Phila Pa 1976)"},{"key":"2025061802001081000_2025.06.10.25327236v1.6","doi-asserted-by":"publisher","DOI":"10.1186\/s12913-018-3699-0"},{"key":"2025061802001081000_2025.06.10.25327236v1.7","unstructured":"Company TM. 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