Date of Award
Spring 3-26-2024
Embargo Period
4-2-2024
Document Type
Dissertation
Degree Name
Doctor of Health Administration
Department
Health Administration
College
College of Health Professions
First Advisor
Walter Jones
Second Advisor
Mary Dooley
Third Advisor
Elinor Borgert
Abstract
OBJECTIVES: To examine changes in MRI rates between Pre-COVID-19 period (Feb-April 2019) and COVID-19 period (Feb-April 2020) among commercially insured patients aged 18-60 with a diagnosis of acute LBP, and to analyze differences in patient characteristics and outcomes between the time periods. Additionally, to examine the impact of eMRI on patient outcomes and health care costs for patients in the COVID-19 period.
DESIGN/METHODS: Using IBM® MarketScan® Commercial Database (MarketScan) we performed a quantitative pre-post comparative retrospective observational study of 117,150 total patients to examine adjusted differences in patient characteristics and rates of MRIs between time periods. We analyzed 49,020 patients in COVID-19 period to examine the impact of eMRIs on odds of having lumbar surgery (OR and 95% CI), and on adjusted total cost for health care services in a one-year follow up time.
RESULTS: The most significant between time periods was that eMRI rates decreased 1.41 percentage points from Pre-COVID-19 to COVID-19 period (P,0.0001). In COVID-19 analysis, patients with noMRI had 97.6% lower odds of having lumbar surgery vs eMRI (P<0.0001). The adjusted total health care cost difference between eMRI and noMRI was $7,881 (P<0.0001).
CONCLUSION: COVID-19 time period correlated with a statistically and clinically significant reduction in eMRIs for acute LBP, considering that prior to COVID-19, rates of MRIs were increasing exponentially each year. Results proved the hypothesis and confirmed literature review findings, that eMRIs result in worst patient outcomes, as measured by odds of surgery, and also result in significantly higher health care costs. Even the modest reduction in eMRI rates shown in this study could have a significant impact on costs, estimated at eight billion dollars of annualized savings, based on how many Americans suffer from LBP.
Recommended Citation
Radcliffe, Kimberly, "The Impact of Covid-19 on the Utilization of Early Magnetic Resonance Imaging (eMRI) in the Assessment of Acute Uncomplicated Low Back Pain (LBP) and the Subsequent Effect on Health Care Service Utilization and Patient Outcomes" (2024). MUSC Theses and Dissertations. 840.
https://medica-musc.researchcommons.org/theses/840
Rights
Copyright is held by the author. All rights reserved.