Comparative Analysis of Individuals With and Without Chiropractic Coverage

Antonio P. Legorreta, MD, MPH; R. Douglas Metz, DC; Craig F. Nelson, DC, MS; Saurabh Ray, PhD; Helen Oster Chernicoff, MD, MSHS; Nicholas A. DiNubile, MD.

Background:
Back pain accounts for more than $100 billion in annual US health care costs and is the second leading cause of physician visits and hospitalizations. This study ascertains the effect of systematic access to chiropractic care on the overall and neuromusculoskeletal-specific consumption of health care resources within a large managed-care system.

Methods:
A 4-year retrospective claims data analysis comparing more than 700 000 health plan members with an additional chiropractic coverage benefit and 1 million members of the same health plan without the chiropractic benefit.

Results:
Members with chiropractic insurance coverage, compared with those without coverage, had lower annual total health care expenditures. Having chiropractic coverage was associated with a 1.6% decrease in total annual health care costs at the health plan level. Back pain patients with chiropractic coverage, compared with those without coverage, had lower utilization of plain radiographs, low back surgery, hospitalizations, and magnetic resonance imaging. Patients with chiropractic coverage, compared with those without coverage, also had 26% lower average back pain episode-related costs.

Conclusions:
Access to managed chiropractic care may reduce overall health care expenditures through several effects.

References:
Arch Intern Med. 2004;164:1985-1992.

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