The impact of adherence to clinical practice guidelines on medical costs

Renan C. Castillo, Dorianne Feldman, Eva H. DuGoff, Eric Roberts, Elena D. Staguhn, Stephen Wegener, Gerard Anderson, Antonio Trujillo

Research output: Contribution to journalArticlepeer-review


Objective: To examine the association between non-Adherence to clinical practice guidelines (CPGs) and medical and indemnity spending among back and shoulder injury patients. Methods: Workers compensation claims data was used from a large, US insurer (1999 to 2010). Least square regression models were created to examine the association between spending and guideline-discordant care. Results: Non-Adherence to CPGs was associated with higher medical and indemnity spending for 11 of the 28 CPG indicators. Failure to adhere to the other CPGs did not increase medical or total spending. After covariate adjustment, non-Adherence to these 11 CPGs was associated with spending increases that ranged from $16,000 for physical therapy (PT) to $114,000 for surgery. Conclusions: Our results demonstrate that failure to adhere to a subset of CPG indicators significantly predicts increased medical and indemnity spending for two important occupational injuries.

Original languageEnglish (US)
Pages (from-to)712-717
Number of pages6
JournalJournal of occupational and environmental medicine
Issue number9
StatePublished - Sep 2020


  • Back injuries
  • Occupational injuries
  • Practice guideline
  • Shoulder injuries

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health


Dive into the research topics of 'The impact of adherence to clinical practice guidelines on medical costs'. Together they form a unique fingerprint.

Cite this