– Sarnat and Winterstein (2004) concluded that chiropractors, utilizing alternative therapies improved outcomes and cost offsets compared with primary care physicians utilizing conventional pharmaceutical/surgical therapies alone. The cost offsets were substantial in which the integrative model, “demonstrated decreases of 43% in hospital admissions per 1000, 58,4 % hospital days per 1000, 43,2 % outpatient surgeries and procedures per 1000, and 51,8% pharmaceutical cost reductions when compared with normative conventional medicine IPA performance for the same time frame.” Furthermore authors found that the cost savings of their model occurred during the first calendar year! Full Text Study.

– Legoretta AP, Metz RD, et al. (2004) evaluated four years of retrospective claims data involving back injuries in employees in a study published in the Archieves of Internal Medicine. “The study concluded that employees with chiropractic health plan coverage, as compared to those without, incurred a 41 percent reduction in hospitalizations for back pain and a 32 percent reduction in back surgeries. Overall, the cost per episode of treating back pain was 28 percent less for employees with chiropractic health plan coverage than those without coverage”. Furthermore, this “is the largest (study) ever done comparing back treatment costs for individuals with or without chiropractic health plan coverage. Covering four-year retrospective claims data, the study compared over 700.000 health plan members with chiropractic coverage to 1 million members of the same health plan who had no chiropractic coverage.”

– UK BEAM Trial team (2004 Dec 11) cost effectiveness study as a follow up to the Nov. 29th physical treatments clinical effectiveness study (red number 4), concluded that “Adding spinal manipulation to best care in general practice is effective and cost effective for patients with back pain in the United Kingdom”.

– Mosley, Cohen, and Arnold (1996) concluded that for patients who had back or neck pain, “chiropractic care was substantially more cost effective than conventional care” (281). 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.

– Smith, Monica; Stano, Miron. JMPT (1997). Comparison of health insurance payments and patient utilization patterns for individuals suffering from recurring lumbar and low back pain visiting DC’s vs. MDs. Insurance payments were higher for medically initiated episodes. Those who visited chiropractors paid a lower cost and were also satisfied with the care given. Because of this study suggests that chiropractic care should be given careful attention by employers when using gate-keeper strategies.

– Stano and Smith (1996) found that “(f)or both total payments and total outpatient, the mean cost of chiropractic first episodes ($518 and $477 respectively) is substantially and significantly lower than medical episodes ($1.020 and $598) with much of the difference in total costs because of inpatient costs” (198). First contact chiropractic care for common low back conditions costs substantially less than traditional medical treatment and “deserves careful consideration” by managed care executives concerned with controlling health care spending.

– In a 1998 study, Manga and Agnus urged the Ontario government to lower chiropractic co-payments, which should grant access to more proper and prompt care for those who need it most yet can least afford it: poor and elderly patients. Once the government improves public access to chiropractic care, “direct savings to Ontario’s health care system may be as much as $770 million, will very likely to be $548 million, and will be at least $380 million. The corresponding savings in indirect costs -made up of short and long-term costs of disability – are $3.775 billion, $1.849 billion and $1.225 billion” (3). http://www.chiropractic.on.ca/Manga1A.pdf .

– “The overwhelming body of evidence” shows that chiropractic management of low back pain is more cost effective than medical management, and that “many medical therapies are of questionable validity or are clearly inadequate.” 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 safe and more effective than drugs, bed rest, analgesics, and general practice medical care for managing low back pain. The Manga Report (1993).

– A 1992 review of data from over 200,000 users of chiropractic care in the U.S., reported in the Journal of American Health Policy, stated 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, Ehrhart, and Allenburg 1992, 43).

– Johnson, Marjorie, JMPT (1989), did comparison study of Chiropractic, Medical and Osteopathic Care for Work-Related Sprains/Strains. This study analyzed data on Iowa state record from individuals in Iowa who filed claims for back or neck injuries in 1984. The study compared benefits and the cost of care received by individuals from MDs, DC’s and DO’s. There was a focus on individuals who missed days of work and were compensated because of their injuries. Individuals who visited DC’s missed on average at least 2.3 days less than individuals who visited MDs and 3.8 days less than individuals who saw DO’s. Less money was dispersed as employment compensation on average for individuals who visited DC’s. On average, the disability compensation paid to workers for those who visited DC’s was $263.66, $617.85 for those who visited MDs, and was $1565.05 for those who visited DO’s.

– Joanne Nyiendo and Lester Lamm, JMPT 1991 14(3), examined 201 randomly selected workers’ compensation cases for Oregon Workers Compensation claims that involved low back injuries that were disabling. Study found individuals who visited DC’s less often initially went to the hospital for their injuries than those visiting MDs. Those who visited DC’s often had a history of chronic back pain.

– Joanne Nyiendo, JMPT 1991 14 (4), reported on loss of time for individuals who visited DC’s and those who visited MDs for treatment of low back pain. Median missed days of work for individuals with similar severity of injury was 9.0 days for those visiting DC’s and 11.5 individuals visiting MDs. Individuals visiting chiropractors more often returned to work having missed one or less of work days. There was no difference in time lost for individuals visiting DC’s and MDs with no previous history of low back pain. The median of days missed of work for individuals who had chronic back pain and visited MDs was 34.5 days while the median of days missed of work of those visiting DC’s was 9 days.

References:
Sarnat RL, Winterstein J. “Clinical and Cost Outcomes of an Integrative Medicine IPA”. Journal of Manipulative and Physiological Therapeutics 2004; 27: 336-347.

Legoretta AP, Metz RD, et al. “Comparative analysis of individuals with and without chiropractic coverage: patient characteristics, utilization, and costs”. Archive of Internal Medicine. 2004 Oct 11; 164 (18): 1985 -92.
Mosley, Carrie D., Ilana G. Cohen, and Roy M. Arnold. 1996. “Cost-Effectiveness of Chiropractic in a Managed Care Setting.” American Journal of Managed Care 2, no. 3: 280-282.

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

Manga, Pran, Doug Agnus. 1998. Enhanced Chiropractic Coverage under OHIP as a Means of Reducing Health Care Costs, Attaining Better Health Outcomes and Achieving Equitable Access to Health Services. (online). http://www.chiropractic.on.ca.

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.

Nyiendo, Joanne, Lamm, Lester. “Disability Low Back Oregon Workers’ Compensation Claims. Part 1: Methodology and Clinical Categorization of Chiropractic and Medical Cases.” Journal of Manipulative and Physiological Therapeutics 1991 14(3): 177-184.