Keesler medic awarded grant to study low back pain therapy

Published Feb. 8, 2012
By Steve Pivnick
81st Medical Group Public Affairs

KEESLER AIR FORCE BASE, Miss. -- Lt. Col. John Childs, 81st Surgical Operations Squadron Physical Therapy Department director of musculoskeletal research, has been awarded a $125,000 grant from the Air Force Medical Service for his protocol "Implications of Timing and Quality of Physical Therapy on Low Back Pain Utilization and Costs in the Military Health System."

Childs said the purpose of the almost year-long study at the Keesler Hospital is to describe the current referral patterns to physical therapy by primary care providers within the Military Health System for patients with a new episode of low back pain.

The study hopes to determine whether early access to physical therapy and care that adheres to practice guideline recommendations results in lower health care utilization and costs down the road compared to late access to physical therapy and/or care that is not consistent with practice guidelines.

He explained, "We expect that that early referral to physical therapy and care that adheres to practice guideline recommendations will result in lower downstream health care utilization and costs compared to delayed referral and non-adherent care."

Noting that low back pain affects 80 percent of people during their lifetime, Childs said the total annual direct health care cost in the United States for LBP is estimated to exceed $85 billion. "Second only to the common cold, LBP is also the most frequent reason for visiting a physician in the Military Health System and is a leading cause of medical evacuation in Operations New Dawn and Enduring Freedom.

"Most patients with LBP access care initially through a primary care provider. However, suboptimal primary care management for patients with LBP has been shown to lead to the use of increasingly invasive and costly interventions. Recent evidence suggests that early referral to physical therapy and delivering care that is consistent with best-practice guideline recommendations promotes faster recovery and reduces the need for invasive and costly interventions such as narcotics, spine surgery and injections."

Describing how the study will be conducted, Childs said, "We will extract claims data from the Military Health System's Management Analysis and Reporting Tool, referred to as M2, a powerful ad hoc query tool that enhances support to health-care managers to oversee MHS operations. M2 provides summary and detailed views of population, clinical and financial health utilization data from all MHS regions worldwide and includes data from both the direct care system (care provided in military treatment facilities) and commercial network claims (care provided to MHS beneficiaries at civilian facilities). M2 allows healthcare analysts and decision makers to perform trend analyses, conduct patient and provider profiling studies and conduct business case analyses to maximize health plan efficiency and identify opportunities for transferring health care from the private sector back to MTFs.

"We are fortunate to have access to a rich data set in M2, which is maintained and operated by the TRICARE Management Activity of the MHS."

Childs, a leading physical therapy researcher, is the first to hold the director of musculoskeletal research position at the Keesler Hospital. He also continues to serve as an associate professor in the U.S. Army-Baylor University Doctoral Program in Physical Therapy, located at San Antonio's Fort Sam Houston.