Initiating Care for Low Back Pain in the Emergency Department of the Veterans Health Administration, Impact on the Location of Subsequent Visits

Objectives: Our study objective was to evaluate the location and timing of subsequent Veterans Health Administration care for low back pain (LBP) based on the initial clinic.Veterans can initiate care for LBP through different entry points such as primary care, emergency department (ED), urgent care, or other service line clinics.We examined how different starting points impacted the location and timing of the next LBP encounter.Methods: Veteran Affairs (VA) electronic health records were used to identify veterans with an initial visit for LBP, defined as a visit with an International Classification of Diseases, 10th Revision (ICD-10) LBP-related code after a 365-day period without such a visit, between October 1, 2015, and September 30, 2016.Primary and secondary clinic stop codes were used to identify the initial entry point and stratify the clinics into 3 groups: ED/urgent care, primary care, and all other service lines grouped into "other."The location of the first subsequent visit within 365 days with an ICD-10 code for LBP, if any, was similarly identified.Logistic regression was used to assess the impact of entry