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

doi:10.1097/JOM.0000000000001938

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 journal › Article › peer-review

Abstract

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 language	English (US)
Pages (from-to)	712-717
Number of pages	6
Journal	Journal of occupational and environmental medicine
Volume	62
Issue number	9
DOIs	https://doi.org/10.1097/JOM.0000000000001938
State	Published - Sep 2020

Keywords

Back injuries
Occupational injuries
Practice guideline
Shoulder injuries

ASJC Scopus subject areas

Public Health, Environmental and Occupational Health

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10.1097/JOM.0000000000001938

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title = "The impact of adherence to clinical practice guidelines on medical costs",

abstract = "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.",

keywords = "Back injuries, Occupational injuries, Practice guideline, Shoulder injuries",

author = "Castillo, {Renan C.} and Dorianne Feldman and DuGoff, {Eva H.} and Eric Roberts and Staguhn, {Elena D.} and Stephen Wegener and Gerard Anderson and Antonio Trujillo",

note = "Funding Information: This research was supported by a grant from a large U.S. insurer. We would like to thank Elizabeth Stuart for statistical advice and two anonymous reviewers for their helpful feedback on earlier versions of this paper. Dr Roberts and Dr DuGoff were PhD students in the Department of Health Policy and Manage-ment at the Johns Hopkins School of Public Health when this study was conducted. Publisher Copyright: {\textcopyright} 2020 Lippincott Williams and Wilkins. All rights reserved.",

year = "2020",

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doi = "10.1097/JOM.0000000000001938",

language = "English (US)",

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AU - Staguhn, Elena D.

AU - Wegener, Stephen

AU - Anderson, Gerard

AU - Trujillo, Antonio

N1 - Funding Information: This research was supported by a grant from a large U.S. insurer. We would like to thank Elizabeth Stuart for statistical advice and two anonymous reviewers for their helpful feedback on earlier versions of this paper. Dr Roberts and Dr DuGoff were PhD students in the Department of Health Policy and Manage-ment at the Johns Hopkins School of Public Health when this study was conducted. Publisher Copyright: © 2020 Lippincott Williams and Wilkins. All rights reserved.

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N2 - 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.

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The impact of adherence to clinical practice guidelines on medical costs

Abstract

Keywords

ASJC Scopus subject areas

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