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- Title
A Technology-Enabled Concussion Care Pathway Reduces Costs and Enhances Care.
- Authors
Alberts, Jay L; Modic, Michael T; Udeh, Belinda L; Zimmerman, Nicole; Cherian, Kay; Lu, Xiaoyang; Gray, Robert; Figler, Richard; Russman, Andrew; Linder, Susan M
- Abstract
Background The standardization of care along disease lines is recommended to improve outcomes and reduce health care costs. The multiple disciplines involved in concussion management often result in fragmented and disparate care. A fundamental gap exists in the effective utilization of rehabilitation services for individuals with concussion. Purpose The purpose of this project was to (1) characterize changes in health care utilization following implementation of a concussion carepath, and (2) present an economic evaluation of patient charges following carepath implementation. Design This was a retrospective cohort study. Methods A review of electronic medical and financial records was conducted of individuals (N = 3937), ages 18 to 45 years, with primary diagnosis of concussion who sought care in the outpatient or emergency department settings over a 7-year period (2010–2016). Outcomes including encounter length, resource utilization, and charges were compared for each year to determine changes from pre- to post-carepath implementation. Results Concussion volumes increased by 385% from 2010 to 2015. Utilization of physical therapy increased from 9% to 20% while time to referral decreased from 72 to 23 days post-injury. Utilization of emergency medicine and imaging were significantly reduced. Efficient resource utilization led to a 20.7% decrease in median charges (estimated ratio of means [CI] 7.72 [0.53, 0.96]) associated with concussion care. Limitations Encounter lengths served as a proxy for recovery time. Conclusions The implementation of the concussion carepath was successful in optimizing clinical practice with respect to facilitating continuity of care, appropriate resource utilization, and effective handoffs to physical therapy. The utilization of enabling technology to facilitate the collection of common outcomes across providers was vital to the success of standardizing clinical care without compromising patient outcomes.
- Subjects
BRAIN concussion; COST effectiveness; LONGITUDINAL method; MEDICAL quality control; MEDICAL protocols; MEDICAL records; MEDICAL technology; RESEARCH funding; RETROSPECTIVE studies; ACQUISITION of data methodology
- Publication
Physical Therapy, 2020, Vol 100, Issue 1, p136
- ISSN
0031-9023
- Publication type
Article
- DOI
10.1093/ptj/pzz141