Do the number of visits and the cost of musculoskeletal care improve outcomes? More may not be better

Review written by Todd Hargrove info

Key Points

  1. The amount of health care use for treatment of shoulder pain was not associated with changes in pain and disability.
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BACKGROUND & OBJECTIVE

It’s an interesting question isn’t it – is more better when it comes to musculoskeletal care? This study analyzed data from a single randomized controlled trial (RCT) (1) related to different treatments for subacromial pain syndrome (SAPS) to determine whether the number of visits and cost of treatment were associated with patient-reported changes in pain and disability. It also measured the value of care, defined as the change in pain and disability per dollar spent, and compared value of care between high and low-responder groups.

Value of care was defined as the change in pain and disability per dollar spent.
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Patients tend to be more satisfied with health care that involves more visits, even when this does not improve outcomes.

METHODS

The authors used data from an RCT looking at nonsurgical treatment for SAPS. This study included 104 patients who received either a corticosteroid injection or manual therapy plus exercise. The authors divided the patients into high and low responders, based

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