Cost-Effectiveness of Chiropractic
Historically, chiropractors have promoted chiropractic management of back pain as a cost effective approach to alleviating this condition. The following studies support this assertion:
A study conducted in the United States involving 395,641 patients with one or more of 493 neuromusculoskeletal conditions was undertaken to compare the health care costs of patients who have received chiropractic treatment to those treated solely by medical or osteopathic physicians. The results showed that “patients receiving chiropractic care experienced significantly lower health care costs … (with) total cost differences on the order of $1000 over the 2-year period …” The report concluded that”… these preliminary results suggest a significant cost-saving potential for users of chiropractic care.” The report of the study also suggests the need to re-examine insurance practices and programs relative to chiropractic coverage (Stano 1993).
The Florida study on workers’ compensation claims, previously cited in reference to back
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pain, found that “the estimated average total cost of care, computed across all the major categories of treatment cost, was substantially higher for medical patients compared with chiropractic patients…” The authors of the study included that chiropractic care is more cost-effective in the treatment of work-related back injuries than standard medical care (Wow 1988).
A 1988 workers’ compensation study conducted in Utah assessed the total cost per case of chiropractic care versus medical care for conditions with identical diagnostic codes. The results indicated that costs were significantly higher for medical claims than for chiropractic claims, In addition, the number of work days lost for those receiving medical care was nearly 10 times higher than for those who received chiropractic care (Jarvis, Phillips, and Morris 1991).
A comparison of the cost of chiropractic care versus the cost of medical care for various health conditions (predominantly low-back pain, spinal-related sprains, strains, dislocations, arthritis, and disc disorders), revealed that “chiropractic is a lower cost option for several prominent back-related ailments … If chiropractic care is insured to the extent other specialists are stipulated, it may emerge as a first option for patients with certain medical conditions. This could very well result in a decrease in overall treatment costs for these conditions” (Dean and Schrnidt 1992).
A review of data from over two million users of chiropractic care in the United States was reported in the Journal of American Health Policy. Initial analysis indicated that “chiropractic users tend to have substantially lower total health care costs” and “chiropractic care reduces the use of both physician and hospital care” (Stano et al. 1992).
A workers’ compensation study conducted in Oregon (1990) evaluated the loss of working time incurred by chiropractic (DC) and medical (MD) claimants with disabling low-back work-related injuries. Authors of the study concluded that “the median time loss days for cases with comparable clinical presentation (severity) was 9.0 for DC cases and 11.5 for MD cases. Chiropractic claimants had a higher frequency of return to work with one week or less of time loss.” (Nyiendo 1991).
A study, published in 1992, compared the cost-effectiveness of chiropractic care to medical care in the commonwealth of Virginia. The report of the study indicated that chiropractic:
1. has minimal cost-increasing effects on insurance and may in fact reduce insurance costs.
2. provides important therapeutic benefits at economical costs.
This study also recommended that chiropractic care be a widely available form of health care, and noted that it is a growing and widely used component of the health care sector (Schifrin 1992).