Cost effectiveness

Comparing Costs With and Without Chiropractic Coverage.
A 4-year retrospective claims data analysis compared more than 700,000 health plan members with chiropractic coverage and 1 million members of the same health plan without the chiropractic benefit.

Findings included the following:
Members with chiropractic insurance coverage, compared to those without coverage, had lower annual total health care expenditures ($1463 vs $1671 per member per year).

Back pain patients with chiropractic coverage, compared to those without coverage, had lower utilization (per 1000 episodes) of x-ray imaging (17.5 vs 22.7), low back surgery (3.3 vs 4.8), hospitalizations (9.3 vs 15.6), and magnetic resonance imaging (43.2 vs 68.9).

Patients with chiropractic coverage, compared with those without coverage, also had lower average back pain episode-related costs ($289 vs $399).

Conclusions Access to managed chiropractic care may reduce overall health care expenditures through several effects, including (1) improved selection of appropriate treatment; (2) substitution of chiropractic for traditional medical care, particularly for spine conditions; (3) more conservative, less invasive treatments, and (4) lower health service costs associated with managed chiropractic care.

Antonio P. Legorreta, MD, MPH; R. Douglas Metz, DC; "Comparative Analysis of Individuals With and Without Chiropractic Coverage" Archives of Internal Medicine Vol. 164 No. 18, October 11, 2004

Clinical and Cost Outcomes of an Integrative Medicine IPA.
This is the first study to compare the costs and the clinical outcomes of a group of patients using doctors of chiropractic as their primary care physicians (PCP's) versus those using medical doctors.

The analysis of clinical and cost outcomes on 21,743 member-months over a 4-year period demonstrated significant benefits for those using chiropractors as their PCP's:
- 43% decrease in hospital admissions
- 58% decrease in hospital days
- 43.2% decrease in outpatient surgeries and procedures
- 51.8% pharmaceutical cost reductions
when compared with normative conventional medicine IPA performance for the same HMO product in the same geography over the same time.

This study emerged out of the need to rethink this country's current medical model with its overreliance on drugs as a first line of defense. Although this pioneer study was performed with a limited population, the results were very encouraging and may represent a new model of health care delivery.

Sarnat, Richard,M.D., Winterstein, D.C. "Clinical and Cost Outcomes of an Integrative Medicine IPA". Journal of Manipulative Physiological Therapeutics 2004,:27:336-47.

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