Patient Satisfaction

First-Contact Care With a Medical vs Chiropractic Provider

By Frank M. Painter|August 23, 2015|Musculoskeletal Complaints, Patient Satisfaction|

First-Contact Care With a Medical vs Chiropractic Provider After Consultation With a Swiss Telemedicine Provider: Comparison of Outcomes, Patient Satisfaction, and Health Care Costs in Spinal, Hip, and Shoulder Pain Patients

SOURCE: J Manipulative Physiol Ther. 2015 (Aug 15)]

Taco A.W. Houweling, DC, MRes, PhD,
Andrea V. Braga, MD, MBA,
Thomas Hausheer, DC, arco Vogelsang, DC,
Cynthia Peterson, RN, DC, MMedEd,
B. Kim Humphreys, DC, PhD

Department of Chiropractic Medicine,
University Hospital Balgrist, Forchstrasse 340, 8008
Zürich, Switzerland.

OBJECTIVE: The purpose of this study was to identify differences in outcomes, patient satisfaction, and related health care costs in spinal, hip, and shoulder pain patients who initiated care with medical doctors (MDs) vs those who initiated care with doctors of chiropractic (DCs) in Switzerland.

METHODS: A retrospective double cohort design was used. A self-administered questionnaire was completed by first-contact care spinal, hip, and shoulder pain patients who, 4 months previously, contacted a Swiss telemedicine provider regarding advice about their complaint. Related health care costs were determined in a subsample of patients by reviewing the claims database of a Swiss insurance provider.

RESULTS: The study sample included 403 patients who had seen MDs and 316 patients who had seen DCs as initial health care providers for their complaint. Differences in patient sociodemographic characteristics were found in terms of age, pain location, and mode of onset. Patients initially consulting MDs had significantly less reduction in their numerical pain rating score (difference of 0.32) and were significantly less likely to be satisfied with the care received (odds ratio = 1.79) and the outcome of care (odds ratio = 1.52). No significant differences were found for Patient’s Global Impression of Change ratings. Mean costs per patient over 4 months were significantly lower in patients initially consulting DCs (difference of CHF 368; US $368).

There are more articles like this @ our:

Low Back Pain and Chiropractic Page

and our:

The Shoulder Girdle & Chiropractic Page

(more…)

0

Chiropractic Use in the Medicare Population

By Frank M. Painter|November 9, 2014|Medicare, Patient Satisfaction|

Chiropractic Use in the Medicare Population: Prevalence, Patterns, and Associations With 1-Year Changes in Health and Satisfaction With Care

The Chiro.Org Blog

SOURCE: J Manipulative Physiol Ther. 2014 (Oct); 37 (8): 542-551 ~ FULL TEXT

Paula A.M. Weigel, PhD, Jason M. Hockenberry, PhD,
Fredric D. Wolinsky, PhD

Research Associate,
Department of Health Management and Policy,
College of Public Health,
The University of Iowa, Iowa City, IA.
Paula-Weigel@uiowa.edu

OBJECTIVE: The purpose of this study was to examine how chiropractic care compares to medical treatments on 1-year changes in self-reported function, health, and satisfaction with care measures in a representative sample of Medicare beneficiaries.

METHODS: Logistic regression using generalized estimating equations is used to model the effect of chiropractic relative to medical care on decline in 5 functional measures and 2 measures of self-rated health among 12170 person-year observations. The same method is used to estimate the comparative effect of chiropractic on 6 satisfaction with care measures. Two analytic approaches are used, the first assuming no selection bias and the second using propensity score analyses to adjust for selection effects in the outcome models.

RESULTS: The unadjusted models show that chiropractic is significantly protective against 1-year decline in activities of daily living, lifting, stooping, walking, self-rated health, and worsening health after 1 year. Persons using chiropractic are more satisfied with their follow-up care and with the information provided to them. In addition to the protective effects of chiropractic in the unadjusted model, the propensity score results indicate a significant protective effect of chiropractic against decline in reaching.

(more…)

4

Exploring Patient Satisfaction

By Frank M. Painter|September 24, 2014|Chiropractic Care, Patient Satisfaction|

Exploring Patient Satisfaction: A Secondary Analysis of a Randomized Clinical Trial of Spinal Manipulation, Home Exercise, and Medication for Acute and Subacute Neck Pain

The Chiro.Org Blog

SOURCE: J Manipulative Physiol Ther 2014 (Sep 5)

Brent D. Leininger, DC, Roni Evans, DC, PhD,
Gert Bronfort, DC, PhD

Research Fellow, Integrative Health & Wellbeing Research Program,
Center for Spirituality & Healing, University of Minnesota,
Minneapolis, MN.
lein0122@umn.edu

OBJECTIVE: The purpose of this study was to assess satisfaction with specific aspects of care for acute neck pain and explore the relationship between satisfaction with care, neck pain, and global satisfaction.

METHODS: This study was a secondary analysis of patient satisfaction from a randomized trial of spinal manipulation therapy (SMT) delivered by doctors of chiropractic, home exercise and advice (HEA) delivered by exercise therapists, and medication (MED) prescribed by a medical doctors for acute/subacute neck pain. Differences in satisfaction with specific aspects of care were analyzed using a linear mixed model. The relationship between specific aspects of care and (1) change in neck pain (primary outcome of the randomized trial) and (2) global satisfaction were assessed using Pearson’s correlation and multiple linear regression.

RESULTS: Individuals receiving SMT or HEA were more satisfied with the information and general care received than MED group participants. Spinal manipulation therapy and HEA groups reported similar satisfaction with information provided during treatment; however, the SMT group was more satisfied with general care. Satisfaction with general care (r = -0.75 to -0.77; R2 = 0.55-0.56) had a stronger relationship with global satisfaction compared with satisfaction with information provided (r = -0.65 to 0.67; R2 = 0.39-0.46). The relationship between satisfaction with care and neck pain was weak (r = 0.17-0.38; R2 = 0.08-0.21).

There are more articles like this @ our:

Patient Satisfaction With Chiropractic Page

(more…)

0

There Will Never Be Enough Research To Satisfy Our Critics

By Frank M. Painter|January 24, 2013|Chiropractic Care, Evidence-based Medicine, Health Care Reform, Patient Satisfaction, Spinal Manipulation|

There Will Never Be Enough Research To Satisfy Our Critics

The Chiro.Org Blog

A Chiro.Org Editorial

For some, there will never be enough research to support the use of chiropractic. These people will forever hide behind the claim that they wish to protect patients from quackish practices.

For those who may have forgotten, or for those who never knew, organized medicine spent decades and tens of millions of dollars trying to discredit and destroy chiropractic. Today, the vestiges of that oppression is still found on fringe web sites that ignore the body of peer-reviewed research supporting chiropractic care.

The Wilk anti-trust case against the AMA and 20 other named medical groups revealed that the AMA Plan was to:

Undermine Chiropractic schools
Undercut insurance programs for Chiropractic patients
Conceal evidence of the effectiveness of Chiropractic care
Subvert government inquires into the effectiveness of Chiropractic, and
Promote other activities that would control the monopoly that the AMA had on health care
They even threatened their own ranks: any MD who taught in our schools, performed research with chiropractors, or accepted a referral from, or made a referral to a chiropractor, would lose their hospital privileges, leaving them unable to treat patients.

while, all along, they knew that:<

There also was some evidence before the Committee that chiropractic was effective – more effective than the medical profession in treating certain kinds of problems such as workmen’s back injuries.

The Committee on Quackery was also aware that some medical physicians believed chiropractic to be effective and that chiropractors were better trained to deal with musculoskeletal problems than most medical physicians.
(Opinion pp. 7)

(more…)

9

Symptomatic Reactions, Clinical Outcomes and Patient Satisfaction

By Frank M. Painter|August 16, 2012|Patient Satisfaction, Safety, Upper Cervical Adjusting|

Symptomatic Reactions, Clinical Outcomes and Patient Satisfaction Associated with Upper Cervical Chiropractic Care: A Prospective, Multicenter, Cohort Study

The Chiro.Org Blog

SOURCE: BMC Musculoskelet Disord. 2011 (Oct 5); 12: 219

Kirk Eriksen, Roderic P Rochester, and Eric L Hurwitz

Chiropractic Health Institute, PC, Clinic Director, 2500 Flowers Chapel Road, Dothan, AL 36305, USA. drkirke@graceba.net

BACKGROUND: Observational studies have previously shown that adverse events following manipulation to the neck and/or back are relatively common, although these reactions tend to be mild in intensity and self-limiting. However, no prospective study has examined the incidence of adverse reactions following spinal adjustments using upper cervical techniques, and the impact of this care on clinical outcomes.

METHODS: Consecutive new patients from the offices of 83 chiropractors were recruited for this practice-based study. Clinical outcome measures included:

Neck pain disability index (100-point scale),
Oswestry back pain index (100-point scale),
11-point numerical rating scale (NRS) for neck, headache, midback, and low back pain,
treatment satisfaction, and
Symptomatic Reactions (SR).

Data were collected at baseline, and after approximately 2 weeks of care. A patient reaching sub-clinical status for pain and disability was defined as a follow-up score <3 NRS and <10%, respectively. A SR is defined as a new complaint not present at baseline or a worsening of the presenting complaint by >30% based on an 11-point numeric rating scale occurring <24 hours after any upper cervical procedure.

RESULTS: A total of 1,090 patients completed the study having 4,920 (4.5 per patient) office visits requiring 2,653 (2.4 per patient) upper cervical adjustments over 17 days. Three hundred thirty- eight (31.0%) patients had SRs meeting the accepted definition. Intense SR (NRS ≥8) occurred in 56 patients (5.1%). Outcome assessments were significantly improved for neck pain and disability, headache, mid-back pain, as well as lower back pain and disability (p <0.001) following care with a high level (mean = 9.1/10) of patient satisfaction. The 83 chiropractors administered >5 million career upper cervical adjustments without a reported incidence of serious adverse event.

CONCLUSIONS: Upper cervical chiropractic care may have a fairly common occurrence of mild intensity SRs short in duration (<24 hours), and rarely severe in intensity; however, outcome assessments were significantly improved with less than 3 weeks of care with a high level of patient satisfaction. Although our findings need to be confirmed in subsequent randomized studies for definitive risk-benefit assessment, the preliminary data shows that the benefits of upper cervical chiropractic care may outweigh the potential risks.

From the FULL TEXT Article:

Discussion: (more…)

0

Cervical Radiculopathy: A Systematic Review on Treatment by Spinal Manipulation and Measurement with the Neck Disability Index

By Frank M. Painter|June 4, 2012|Chiropractic Care, Patient Satisfaction, Radiculopathy|

Cervical Radiculopathy: A Systematic Review on Treatment by Spinal Manipulation and Measurement with the Neck Disability Index

The Chiro.Org Blog

SOURCE: J Can Chiro Assoc. 2012 (Mar); 56 (1): 18–28 ~ FULL TEXT

Robert J. Rodine, BSc, DC, Howard Vernon, DC, PhD, FCCS(C)

Graduate Education and Research Programs,
Canadian Memorial Chiropractic College,
Toronto, Ontario.

Cervical radiculopathy (CR), while less common than conditions with neck pain alone, can be a significant cause of neck pain and disability; thus the determination of adequate treatment options for patients is essential. Currently, inadequate scientific literature restricts specific conservative management recommendations for CR. Despite a paucity of evidence for high-velocity low-amplitude (HVLA) spinal manipulation in the treatment for CR, this strategy has been frequently labeled as contraindicated. Scientific support for appropriate outcome measures for CR is equally deficient. While more scientific data is needed to draw firm conclusions, the present review suggests that spinal manipulation may be cautiously considered as a therapeutic option for patients suffering from CR. With respect to outcome measures, the Neck Disability Index appears well-suited for spinal manipulative treatment of CR.

There are other similar articles at the:

Radiculopathy and Chiropractic Page

From the FULL TEXT Article

Introduction

Cervical radiculopathy (CR) can be a significant cause of neck pain and disability. The reported annual incidence of CR is 83.2/100,000 persons [1], while the reported prevalence is 3.5/1000 persons. [2] Gender preference varies. [2, 3] Individuals are most commonly affected in the 5th and 6th decades of life. [1, 4] Physical exertion or trauma at onset is rare, involving less than 15%. [1] Causal relationship to an automobile accident ranges from 3–23%. [1, 4] (more…)

0