HealthDay News — For new entries into health care with low back pain (LBP), the provider chosen for entry is associated with future health care utilization, according to research published in the Journal of Evaluation in Clinical Practice.

Julie M. Fritz, PhD, PT, from the University of Utah in Salt Lake City, and colleagues conducted a retrospective review of claims data to identify new entries into health care for LBP. Utilization outcomes and total costs related to LBP were examined in the year after health care entry for 747 patients.

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The researchers found that entry setting was primary care, chiropractic, physiatry, and physical therapy for 54.8, 27.7, 11.1, and 6.4% of patients, respectively. Entry into physiatry correlated with increased risk for radiographs, advanced imaging, injections, surgery, and LBP-related costs compared with primary care. Decreased risk of advanced imaging or a surgeon visit was seen for entry in chiropractic, together with increased episode of care duration. The risk of radiographs was decreased with entry in physical therapy, and no patient had surgery who entered through physical therapy.

“Entry setting for LBP was associated with future health care utilization and costs,” the authors wrote. “Consideration of where patients chose to enter care may be a strategy to improve outcomes and reduce costs.”


1. Fritz J, Kim J, Dorius J. Importance of the type of provider seen to begin health care for a new episode low back pain: associations with future utilization and costs. J Eval Clin Pract. 2015:n/a-n/a. doi:10.1111/jep.12464.