Implementing the Keele stratified care model for patients with low back pain: an observational impact study

Table 5 Estimated change to back-related NHS costs and QALYs associated with introducing stratified care in Gloucestershire

stratified care model risk category	% patients in risk category^a	mean incremental costs and QALYs per patient over 6 months associated with the stratified care model:^b				annual referrals for LBP physio. in Glos.^c	annual incremental impact for Gloucestershire:
		Costs (£)			QALYs	annual referrals for LBP physio. in Glos.^c	NHS cost (£ 1000)	QALY gain	NMB^d (£ 1000)
		NHS	private	total
Low	29	−6.58	9.85	3.27	0.003	1531	−10.1	4.6	147.9
Medium	38	14.96	−23.52	−8.56	−0.007	1973	29.5	−13.8	−443.8
High	33	−13.33	−122.61	−135.93	0.023	1713	−22.8	39.4	1204.8
Total	100	−0.65	−46.26	−46.91	0.006	5217	−3.4	30.2	909.0

physio physiotherapy, Glos Gloucestershire, NMB net monetary benefit
^aSource: GHT audits (Table 1)
^bSource: IMPaCT Back study [13, Table 3]. Costs up-rated to 2014/15 values using the HCHS index [31]: private costs extrapolated from NHS and total (healthcare) costs
^cSource: 20% [10, 30] of 26,085, the estimated annual consulting prevalence for LBP in primary care [3] applied to Gloucestershire gender and age-specific population rates for 2013 [31]
^dassuming a cost-effectiveness threshold of £30,000 per QALY

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