{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T07:51:13Z","timestamp":1772956273867,"version":"3.50.1"},"reference-count":32,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2015,7,7]],"date-time":"2015-07-07T00:00:00Z","timestamp":1436227200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100002594","name":"American Osteopathic Association","doi-asserted-by":"crossref","award":["10-11-621"],"award-info":[{"award-number":["10-11-621"]}],"id":[{"id":"10.13039\/100002594","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Evaluation Clinical Practice"],"published-print":{"date-parts":[[2015,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Rationale, aims and objectives<\/jats:title><jats:p>Although several studies have compared patient outcomes by provider specialty in the treatment of back and joint pain, little is known about the cost\u2010effectiveness of improving patient outcomes across specialties. This study uses a large\u2010scale, nationally representative database to evaluate the cost\u2010effectiveness of being treated by specific provider specialists for back and joint pain in the United States.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>The 2002\u20132012 <jats:styled-content style=\"fixed-case\">M<\/jats:styled-content>edical <jats:styled-content style=\"fixed-case\">E<\/jats:styled-content>xpenditure <jats:styled-content style=\"fixed-case\">P<\/jats:styled-content>anel <jats:styled-content style=\"fixed-case\">S<\/jats:styled-content>urveys were used to examine patients diagnosed with back and\/or joint problems seeking treatment from doctors (internal medicine, family\/general, osteopathic medicine, orthopaedics, rheumatology, neurology) or other providers (chiropractor, physical therapist, acupuncturist, massage therapist). A total of 16\u2009546 respondents aged 18 to 85 and clinically diagnosed with back\/joint pain were examined. Self\u2010reported measures of physical and mental health and general quality of life (measured by the <jats:styled-content style=\"fixed-case\">EuroQol\u20105D<\/jats:styled-content>) were compared with average total costs of treatment across medical providers.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Total annual treatment costs per person ranged from $397 for family\/general doctors to $1205 for rheumatologists. Cost\u2010effectiveness analysis suggests that osteopathic, family\/general, internal medicine doctors and chiropractors and massage therapists were more cost\u2010effective than other specialties in improving physical function to back pain patients. For mental health measures, family\/general and orthopaedic doctors and physical therapists were more cost\u2010effective compared with other specialties. Similar to results on physical function, family\/general, osteopathic and internal medicine doctors dominated other specialties. However, only massage therapy was cost\u2010effective among non\u2010doctor providers in improving quality of life measures.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Patients seeking care for back and joint\u2010related health problems face a wide range of treatments, costs and outcomes depending on which specialist provider they see. This study provides important insight on the relationship between health care costs and patients' perceived physical and mental health status from receiving treatment for diagnosed back\/joint problems.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jep.12411","type":"journal-article","created":{"date-parts":[[2015,7,7]],"date-time":"2015-07-07T12:33:04Z","timestamp":1436272384000},"page":"952-957","source":"Crossref","is-referenced-by-count":8,"title":["Analysis of provider specialties in the treatment of patients with clinically diagnosed back and joint problems"],"prefix":"10.1111","volume":"21","author":[{"given":"Fernando A.","family":"Wilson","sequence":"first","affiliation":[{"name":"College of Public Health University of Nebraska Medical Center  Omaha NE USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John C.","family":"Licciardone","sequence":"additional","affiliation":[{"name":"The Osteopathic Research Center University of North Texas Health Science Center  Fort Worth TX USA"},{"name":"Department of Medical Education University of North Texas Health Science Center  Fort Worth TX USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cathleen M.","family":"Kearns","sequence":"additional","affiliation":[{"name":"The Osteopathic Research Center University of North Texas Health Science Center  Fort Worth TX USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mathias","family":"Akuoko","sequence":"additional","affiliation":[{"name":"Department of Health West Chester University of Pennsylvania  West Chester PA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2015,7,7]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.299.6.656"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.BRS.0000105527.13866.0F"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.spinee.2003.06.002"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/00007632-199501000-00003"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199810083391502"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.1780370104"},{"issue":"43","key":"e_1_2_9_8_1","first-page":"1","article-title":"Osteopathic manipulative treatment for low back pain: a systematic review and meta\u2010analysis of randomized controlled trials","volume":"6","author":"Licciardone J. 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