Cost Effectiveness of Chiropractic Care

The following is a sample of some research studies which prove the cost effectiveness of Chiropractic treatment:

Manga, Pran. “Enhanced Chiropractic coverage under OHIP ( Ontario Health Insurance Plan) as a Means for Reducing Health Care Costs, Attaining Better Health Outcomes and Achieving Equitable Access to Health Services.” Report to the Ontario Ministry of Health, 1998.

This study demonstrates the ways in which individuals in Ontario are deterred from the use of Chiropractic care because it is not covered under OHIP. Greater Chiropractic coverage under OHIP would result in a greater number of individuals visiting chiropractors and going more often. The study shows that despite increased visits to DCs, this would result in net savings in both direct and indirect costs. It is very costly to manage neuromusculoskeletal disorders using traditional medicine. If individuals were able to visit chiropractors under OHIP, a great deal of money would be saved by the government. Direct savings for Ontario ‘s healthcare system could be as much as $770 million and at the very least $380 million.

Manga, Pran; Angus, Doug; Papadopoulos, Costa; Swan, William. “The Effectiveness and Cost-Effectiveness of Chiropractic Management of Low-Back Pain.” Richmond Hill , Ontario : Kenilworth Publishing, 1993

This study demonstrates that an increase in the use of Chiropractic care to manage low back pain would save an enormous amount of money. The study reveals that if management of low back pain was taken from physicians and given to chiropractors there could be a potential savings of millions of dollars every year. The study also revealed that spinal manipulation is both safer and more effective than drugs, bed rest, analgesics, and general practice medical care for managing low back pain.

Mosley, Carrie; Cohen, Ilava; Arnold, Roy . “Cost-effectiveness of Chiropractic Care in a Managed Care Setting.” The American Journal of Managed Care 1996; 2: 280-282.

In this study, the cost of health care for back or neck pain for individuals belonging to an HMO who used Chiropractic care or other methods of treatment were evaluated. In this study the cost of surgery, use of diagnostic imaging, and the satisfaction of patients were evaluated. Claims that were paid from October 1, 1994 through October 1, 1995 were evaluated and analyzed. The cost of healthcare for back and neck pain was much lower for patients using Chiropractic care than those using other treatments. Surgical costs and the satisfaction of patients was nearly the same for those who used Chiropractic care and those who did not. The conclusion of the study is that Chiropractic care yields similar outcomes to other forms of care at a much lower cost.

Dean, David; Schmidt, Robert. “A Comparison of the Cost of Chiropractors Versus Alternative Medical Practitioners.” Richmond , VA : Virginia Chiropractic Association, 1992.

This study is an assessment of the difference in the cost of treatment between chiropractors and other practitioners in dealing with individuals who have similar back-related problems. This study analyzed individuals who had medical visits in 1980 and had a combination of eleven health problems including arthritis, disc disorders, bursitis, low back pain, spinal related sprains, strains, and dislocations. Chiropractic care was a lower cost option for many back ailments.

Wolk, Steve. “An Analysis of Florida Workers’ Compensation Medical Claims for Back-Related Injuries.” Journal of the American Chiropractic Association 1988; 27(7): 50-59.

This study is an analysis of workers’ compensation claims in Florida from June through December of 1987. All of the claims analyzed were related to back injuries. The greater purpose of this study was to compare the cost of osteopathic, medical and Chiropractic doctors. The cost of drugs were not included in the analysis. The results of the study led to the finding that individuals who had compensable injuries and were treated by chiropractors often times were not forced to be hospitalized. The study also stated that Chiropractic care is a “relatively cost-effective approach to the management of work-related injuries.”

Johnson, Marjorie. “A Comparison of Chiropractic, Medical and Osteopathic Care for Work-Related Sprains/Strains.” Journal of Manipulative and Physiological Therapeutics 1989; 12(5): 335-344.

This study analyzed claims data from patients in Iowa who filed claims for back or neck injuries in 1984. The study compared the benefits and the cost of care received by patients from MDs, DCs and DOs. There was a focus on individuals who missed days of work and were compensated because of their injuries. Individuals who visited DCs missed on average at least 2.3 days less than individuals who visited MDs and 3.8 days less than individuals who saw DOs. Less money was dispersed as employment compensation on average for individuals who visited DCs. On average, the disability compensation paid to workers for those who visited DCs was $263.66, $617.85 for those who visited MDs, and $1565.05 for those who visited DOs.

Nyiendo, Joanne, Lamm, Lester. “Disability Low Back Oregon Workers’ Compensation Claims. Part I: Methodology and Clinical Categorization of Chiropractic and Medical Cases.” Journal of Manipulative and Physiological Therapeutics 1991 14(3): 177-184.

This study examined 201 randomly selected workers’ compensation cases that involved disabling low back injuries. The study found that patients who visited a Chiropractor, went to the hospital for their injuries less often than patients who visited an MD. Those who visited DCs often had a history of chronic back pain.

Nyiendo, Joanne. “Disability Low Back Oregon Workers’ Compensation Claims. Part II: Time Loss.” Journal of Manipulative and Physiological Therapeutics 1991 14(4): 231-239.

This study was a report on the loss of time from work for people who visited DCs, versus those who visited MDs for treatment of low back pain. The median missed days of work for individuals with a similar severity of injury was 9.0 days for those visiting DCs and 11.5 for individuals visiting MDs. Individuals visiting chiropractors more often returned to work having missed one week or less of work days. There was no difference in time lost for individuals visiting DCs and MDs with no previous history of low back pain. The median days of missed work for individuals who had chronic back pain and visited MDs was 34.5 days while the median days of missed work for those visiting DCs was 9 days.

Branson, Richard. “Cost Comparison of Chiropractic and Medical Treatment of Common Musculoskeletal Disorders: A Review of the Literature after 1980.” Topics in Clinical Chiropractic. 1999; 6(2): 57-68.

This study was a comparison of the cost of care provided by DCs and MDs for individuals with musculoskeletal conditions. The study found that the majority of retrospective studies had positive results for Chiropractic care.

Jarvis, Kelly; Phillips, Reed; Morris, Elliot. “Cost Per Case Comparison of Back Injury Claims of Chiropractic versus Medical Management for Conditions with Identical Diagnostic Codes.” Journal of Occupational Medicine 1991; 33(8): 847-852.

This study was a comparison of the costs between MD and DC providers for back-related injuries. The average number of treatments for medical claims was 4.93 as compared to 12.89 for Chiropractic claims. The average treatment length was 34.25 days for medical claims versus only 54.49 days for Chiropractic claims. The average compensation cost for work time lost was $668.39 for medical claims and $68.38 for Chiropractic claims. The average cost of care for medical claims was $684.15 versus $526.84 for Chiropractic claims. This study demonstrates that although individuals who receive Chiropractic care usually have a greater number of visits to DCs than those who visit MDs, the cost of treatment and the workers’ compensation funds spent are lower for those visiting DCs.

Stano, Miron. “A Comparison of Health Care Costs for Chiropractic and Medical Patients.” Journal of Manipulative and Physiological Therapeutics 1993: 16(5): 291-299.

This study was a comparison of the costs for patients who received Chiropractic care for neuromusculoskeletal problems versus those who received medical and osteopathic care. A fourth of patients analyzed were treated by chiropractors. These patients had lower health care costs overall. “Total cost differences on the order of $1000 over the two year period were found in the total sample of patients as well as in sub-samples of patients with specific disorders.” Lower costs were attributed to lower inpatient utilization.

Stano, Miron. “The Economic Role of Chiropractic; Further Analysis of Relative Insurance Costs for Low Back Care.” Journal of the Neuromusculoskeletal System 1995; 3(3): 139-144.

This study was a comparison of the costs of care for common lumbar and low back conditions when a chiropractor is the first provider and when an MD is the first provider. Total payments for inpatient procedures were higher for MD episodes and especially episodes that lasted longer than a single day. Outpatient payments were much higher for MD initiated treatments as well.

Stano, Miron; Smith, Monica. “Chiropractic and Medical Costs of Low Back Care.” Medical Care 34(3): 191-204.

This study was a comparison of health insurance payments and patient utilization patterns for common lumbar and low back pain for patients who receive treatment from MDs and DCs. The results found that there were lower costs for episodes in which DCs were the first providers. The mean total payment when DCs were the first providers was $518, whereas the mean payment for cases in which a MD was the first provider was $1020.

Smith, Monica; Stano, Miron. “Costs and Recurrences of Chiropractic and Medical Episodes of Low Back Care.” Journal of Manipulative and Physiological Therapeutics 1997: 20(1): 5-12.

This study was a comparison of health insurance payments and patient utilization patterns for individuals suffering from recurring lumbar and low back pain visiting DCs versus MDs. Insurance payments were higher for medically initiated episodes. Those who visited chiropractors paid a lower cost and were also more satisfied with the care given. Because of this the study suggests that Chiropractic care should be given careful attention by employers when using gate-keeper strategies.

“Utilization, Cost, and Effects of Chiropractic Care on Medicare Program Costs.” Muse and Associates. American Chiropractic Association 2001.

This study examines the cost, utilization and effects of Chiropractic services on Medicare costs. The study compared program payments and service utilization for Medicare beneficiaries who visited DCs with those who visited other types of physicians. The results indicated that Chiropractic care could reduce Medicare costs. Medicare beneficiaries who had Chiropractic care had an average Medicare payment of $4,426 for all Medicare services. Those who had other types of care experienced an average cost of $8,103 in Medicare payments. The average payment per claim was also lower with Chiropractic patients having an average of $133 per claim and individuals who did not have Chiropractic care had an average of $210 per claim.

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