The Impact Of Florida's Low-Back Practice Guideline on Treatment of New Workers' Compensation Injuries

Issue title: Feature Section: The Impact of Florida's Low-Back Practice Guideline on Treatement of New Workers' Compensation Injuries

Article type: Research Article

Authors: State of Florida Agency for Health Care Administration, State Center for Health Statistics,

Abstract: Summary:Low-back injuries are among the most common and costly work-related injuries. Many studies show a wide variation in the diagnostic and therapeutic approaches to treat these injuries. To help standardize medical practice patterns and reduce the use of procedures with little or no proven benefit, the Agency for Health Care Administration (AHCA) developed and endorsed a scientifically sound medical practice guideline for the treatment of low-back injuries.This study investigates the potential of the guideline to reduce workers’ compensation costs by reducing unnecessary diagnostic and therapeutic treatments to workers with low-back injuries. The study considers the universe of new low-back injuries reported to the Department of Labor and Employment Security (DLES) during the period October 1993 through September 1994. As many as two-thirds of the procedures provided to these workers were outside the guideline recommendations. In seven out of 11 procedure categories tested, 50% or more of the procedures were outside the guideline. In five of these areas, as many as 90% of the procedures were outside the guideline. The use of procedures outside the guideline was widespread across all major diagnosis groups, carrier types, geographic regions and practitioner types. Policy Implications:These results suggest that a large percentage of the procedures in use during the study period were unnecessary. Unnecessary procedures represent inessential spending and, in some cases, needless patient risk. The Florida low-back guideline has great potential to reduce practice variation and standardize treatment patterns according to the best scientific evidence. Relevant Florida Statutes:Section 408.02, Florida Statutes, authorizes AHCA to develop and endorse medical practice guidelines. Section 440.13, Florida Statutes, requires workers’ compensation insurance carriers and DLES to use guidelines in evaluating the appropriateness and overutilization of medical services provided to injured employees. For information Contact:Russell E. Mardon, Ph.D or Glenn E. Mitchell, Ph.D., Co-Principal Investigators, State Center for Health Statistics Agency for Health Care Administration. + 1 850 9225866, + 1 850 9225569.

DOI: 10.3233/BMR-1998-11105

Journal: Journal of Back and Musculoskeletal Rehabilitation, vol. 11, no. 1, pp. 35-76, 1998