Disclosures: Patricia Z. Zheng, MD: Nothing to disclose

Objective: We have established an Integrated Spine Service (ISS) where primary care physicians directly refer patients with neck and back conditions to a group of physiatrists, physical therapists and pain management specialists, who co-manage the patients in an effort to improve care and decrease cost. We aim to compare cost between patients who receive care through ISS versus traditional Spine specialist care.

Design: Retrospective, observational study.

Setting: A tertiary, academic medical center.

Participants: Patients seen in traditional Spine specialty clinic or ISS for visit diagnoses of neck and low back pain after being referred by primary care physician.

Interventions: N/A.

Main Outcome Measures: Direct cost associated with visits and care for neck and back pain care over 180 days since initial visit.

Results: In 2018, 409 patients were seen for neck and back pain by a traditional Spine specialist. 53 received care through ISS. 180-day costs were 4533 (std dev 2407), and 3837 (std 1237), respectively. Unpaired t-test reveals that there was significant cost savings (P=.04) when comparing ISS care with traditional Spine specialist care.

Conclusions: A simple restructuring of care delivery to an integrated care model where PCPs can co-manage patients with neck and back conditions with specialists can decrease cost. This preliminary analysis was limited by sample size and duration of follow-up. However, given neck and back pain is so common and costly, we see great need to study how such restructuring of care for neck and back pain can be optimized.

Level of Evidence: Level I

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PM&R Meeting Abstracts - https://pmrjabstracts.org/abstract/reduced-cost-of-spine-care-with-an-integrated-multidisciplinary-approach/