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Cost-Effectiveness

The Association of Complementary and Alternative Medicine Use and Health Care Expenditures for Back and Neck Problems

By |November 17, 2012|Chiropractic Care, Complementary and Alternative Medicine, Cost-Effectiveness|

The Association of Complementary and Alternative Medicine Use and Health Care Expenditures for Back and Neck Problems

The Chiro.Org Blog

SOURCE: Med Care. 2012 (Dec); 50 (12): 1029–1036

The Geisel School of Medicine at Dartmouth & Dartmouth-Hitchcock Medical Center, Department of Orthopaedics, Lebanon, NH

BACKGROUND:   Health care costs associated with use of complementary and alternative medicine (CAM) by patients with spine problems have not been studied in a national sample.

OBJECTIVES:   To estimate the total and spine-specific medical expenditures among CAM and non-CAM users
with spine problems.

RESEARCH DESIGN:   Analysis of the 2002-2008 Medical Expenditure Panel Survey.

SUBJECTS:   Adults (above 17 y) with self-reported neck and back problems who did or did not use CAM services.

MEASURES:   Survey-weighted generalized linear regression and propensity matching to examine penditure differences between CAM users and non-CAM users while controlling for patient, socioeconomic, and health characteristics.

RESULTS:   A total of 12,036 respondents with spine problems were included, including 4306 (35.8%) CAM users (40.8% in weighted sample). CAM users had significantly better self-reported health, education, and comorbidity compared with non-CAM users. (more…)

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Value of Chiropractic Services at an On-site Health Center

By |August 14, 2012|Chiropractic Care, Cost-Effectiveness|

Value of Chiropractic Services at an On-site Health Center

The Chiro.Org Blog

SOURCE:   J Occup Environ Med. 2012 (Aug); 54 (8): 917-921 ~ FULL TEXT

Curt A. Krause, DC; Lisa Kaspin, PhD; Kathleen M. Gorman, MPH; Ross M. Miller, MD, MPH

From the Cerner Healthe Clinic (Dr Krause), Kansas City, MO; Cerner LifeSciences Consulting (Dr Kaspinand and Ms Gorman), Beverly Hills, CA; and Cerner Employer Services (Dr Miller), Cerner Corporation, Beverly Hills, CA.

OBJECTIVE:   Chiropractic care offered at an on-site health center could reduce the economic and clinical burden of musculoskeletal conditions.

METHODS:   A retrospective claims analysis and clinical evaluation were performed to assess the influence of on-site chiropractic services on health care utilization and outcomes.

RESULTS:   Patients treated off-site were significantly more likely to have physical therapy (P < 0.0001) and outpatient visits (P < 0.0001). In addition, the average total number of health care visits, radiology procedures, and musculoskeletal medication use per patient with each event were significantly higher for the off-site group (all P < 0.0001). Last, headache, neck pain, and low back pain-functional status improved significantly (all P < 0.0001).

CONCLUSIONS:   These results suggest that chiropractic services offered at on-site health centers may promote lower utilization of certain health care services, while improving musculoskeletal function.

There are many similar studies in our:

Cost-Effectiveness of Chiropractic Page

 

From the FULL TEXT Article:

Discussion

Although previous research has demonstrated the benefits of chiropractic care, to the best of our knowledge this study is the first to evaluate its impact when offered at an on-site health center. [6–10, 14–17] Given the convenience and quality of care provided by on-site health centers, it was hypothesized that on-site chiropractic care would be more beneficial than off-site clinic care. Despite some limitations that may have weakened the conclusions, the findings suggest on-site chiropractic services are associated with lower health care utilization of certain services and improved functional status of musculoskeletal conditions. (more…)

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Where the U.S. Spends its Spine Dollars

By |June 6, 2012|Chiropractic Care, Cost-Effectiveness, Public Health, Spinal Manipulation|

Where the U.S. Spends its Spine Dollars: Expenditures on Different Ambulatory Services for the Management of Back and Neck Conditions

The Chiro.Org Blog

SOURCE:   Spine (Phila Pa 1976). 2012 (Mar 16)

Davis, Matthew A. DC, MPH; Onega, Tracy PhD;
Weeks, William MD, MBA; Lurie, Jon MD, MS

The Dartmouth Institute for Health Policy and Clinical Practice,
Lebanon, NH 03766, USA

Study Design   Serial, cross-sectional, nationally representative surveys of non-institutionalized adults.

Objective   To examine expenditures on common ambulatory health services for the management of back and neck conditions.

Summary of Background Data   Although it is well recognized that national costs associated with back and neck conditions have grown considerably in recent years, little is known about the costs of care for specific ambulatory health services that are used to manage this population.

Methods   We used the Medical Expenditure Panel Survey (MEPS) to examine adult (age ≥ 18 years) respondents from 1999 to 2008 who sought ambulatory health services for the management of back and neck conditions. We used complex survey design methods to make national estimates of mean inflation-adjusted annual expenditures on medical care, chiropractic care, and physical therapy per user for back and neck conditions.

Results   Approximately 6% of US adults reported an ambulatory visit for a primary diagnosis of a back or neck condition (13.6 million in 2008).

  • Between 1999 and 2008, the mean inflation-adjusted annual expenditures on medical care for these patients increased by 95% (from $487 to $950); most of the increase was accounted for by increased costs for medical specialists, as opposed to primary care physicians. (more…)
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Chiropractic Research & Practice: State of the Art

By |February 24, 2012|Cost-Effectiveness, Evidence-based Medicine, Health Care Reform, Outcome Assessment, Patient Satisfaction, Prevention, Public Health, Research, Spinal Manipulation, Wellness Care|

Chiropractic Research & Practice State of the Art

The Chiro.Org Blog

SOURCE:   Cleveland Chiropractic College

By Daniel Redwood, D.C., professor,
Cleveland Chiropractic College

Peer Reviewers: Carl S. Cleveland III, D.C., J.
Michael Flynn, D.C., Cheryl Hawk, D.C., PhD., and
Anthony Rosner, PhD.

©2010 Cleveland Chiropractic College –
Kansas City and Los Angeles

Chiropractic Research & Practice

State of the Art

Since chiropractic’s breakthrough decade in the 1970s — when the U.S. federal government included chiropractic services in Medicare and federal workers’ compensation coverage, approved the Council on Chiropractic Education (CCE) as the accrediting body for chiropractic colleges, and sponsored a National Institutes of Health (NIH) conference on the research status of spinal manipulation — the profession has grown and matured into an essential part of the nation’s healthcare system.

Chiropractic was born in the United States in the late 19th century and the U.S. is home to approximately 65,000 of the world’s 90,000 chiropractors. [1] The chiropractic profession is the third largest independent health profession in the Western world, after medicine and dentistry. Doctors of chiropractic are licensed throughout the English-speaking world and in many other nations as primary contact providers, licensed for both diagnosis and treatment without medical referral. In 2005, the World Health Organization (WHO) published WHO Guidelines on Basic Training and Safety in Chiropractic, which documented the status of chiropractic education and practice worldwide and sought to ensure high standards in nations where chiropractic is in the early stages of development. [2]

Rigorous educational standards are supervised by government-recognized accrediting agencies in many nations, including CCE in the United States. After fulfilling college science prerequisites similar to those required to enter medical schools, chiropractic students must complete a chiropractic college program of four academic years, which includes a wide range of courses in anatomy, physiology, pathology, and diagnosis, as well as spinal adjusting, physiotherapy, rehabilitation, public health and nutrition. (more…)

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Zen and the Art of Chiropractic Maintenance

By |December 29, 2011|Cost-Effectiveness, Maintenance Care|

Zen and the Art of Chiropractic Maintenance
An Inquiry Into Health Care Values

The Chiro.Org Blog

SOURCE:   Dynamic Chiropractic

By Anthony Rosner, PhD, LLD [Hon.], LLC

With all due respect to Robert Pirsig’s classic tome of the 1970s, [1] the book title couldn’t be more appropriately applied to both the state and lack of recognition of chiropractic health care.

As Pirsig explains in his introduction, the book itself isn’t an expostulation on orthodox Zen Buddhist philosophies, or for that matter motorcycles. Rather, it describes a journey with philosophical reflections along the way.

The same might be said of chiropractic’s own journey, in this case seeking proper recognition. In particular, chiropractic from the point of view of a variety of third-party payers has been repeatedly turned down for reimbursement when it comes to matters of maintenance or preventive therapy. Completely counterintuitive, you might say, in light of the repeated and sometimes urgent declarations that we hear to the effect that the only way to control the runaway costs and inefficiency of American health care is to emphasize preventive care, placing it at the highest rather than lowest priority of interventions. [2]

The evidence from recent research clearly demonstrates that the provision of maintenance or preventive measures from chiropractors appears to deliver tangible benefits, with major impacts upon our health care system:

Cost-Effectiveness

As part of a comprehensive geriatric assessment program, the RAND Corporation studied a subpopulation of patients who were under chiropractic care compared to those who were not, and found that the individuals under continuing chiropractic care were:

  • free from the use of a nursing home (95.7 percent vs. 80.8 percent);
  • free from hospitalizations for the past 23 years (73.9 percent vs. 52.4 percent);
  • more likely to report a better health status;
  • more likely to exercise vigorously;
  • and more likely to be mobile in the community (69.6 percent vs. 46.8 percent).

Although it is impossible to clearly establish causality, it is clear that continuing chiropractic care is among the attributes of the cohort of patients experiencing substantially fewer costly health care interventions. [3] (more…)

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Chiropractic Cost-Effectiveness At Your Fingertips

By |June 26, 2011|Cost-Effectiveness, Research|

Chiropractic Cost-Effectiveness At Your Fingertips

The Chiro.Org Blog

SOURCE:   Virginia Chiropractic Association

The Path to Change in the US Healthcare System:
Chiropractic Cost-Effectiveness

The following is a collection of studies relating to the cost effectiveness and efficacy associated with chiropractic care and the procedures that doctors of chiropractic provide. The American Chiropractic Association, The International Chiropractic Association, The Congress of State Associations, and the Association of Chiropractic Colleges appreciate the opportunity to provide these materials for your review.

All These Articles And More Are Available On Our:
The Cost-Effectiveness of Chiropractic Page

BACKGROUND STUDIES: (Regarding Medical Management)

Prognosis in Patients With Recent Onset Low Back Pain in Australian Primary Care: Inception cohort study
British Medical Journal 2008 (Jul 7); 337: a171 ~ FULL TEXT

This study contradicts Clinical Practice Guidelines that suggest that recovery from an episode of recent onset low back pain is usually rapid and complete.   Their findings with 973 consecutive primary care patients was that recovery was slow for most patients, and almost 1/3 of patients did not recover within after one year, while following standard medical management. This study was designed to determine the one year prognosis of patients with low back pain. 973 patients with low back pain that had lasted less than 2 weeks completed a baseline questionnaire. Patients were reassessed through a phone interview at six weeks, three months and 12 months. The study found that the prognosis claimed in clinical guidelines was more favorable than the actual prognosis for the patients in the study.

(more…)

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