Medical Care 1996 (Mar); 34 (3): 191–204
Stano M, Smith M
School of Business Adminstration,
Rochester, Michigan, USA
This study compared health insurance payments and utilization for episodes of care for common low back conditions treated by chiropractic and medical providers, using 2 years of insurance claims data. The mean total payments were lower for chiropractic care ($518) versus medical care ($1020) as were the mean total outpatient payments ($477 versus $598). The authors concluded that the lower costs for episodes in which chiropractors serve as initial contact providers along with the favourable satisfaction and quality indicators suggests that chiropractic deserves careful consideration in gate keeper strategies adopted by employers and third-party payers to control health care spending.
This study compares health insurance payments and patient utilization patterns for episodes of care for common lumbar and low back conditions treated by chiropractic and medical providers. Using 2 years of insurance claims data, this study examines 6,183 patients who had episodes with medical or chiropractic first-contact providers. Multiple regression analysis, to control for differences in patient, clinical, and insurance characteristics, indicates that total insurance payments were substantially greater for episodes with a medical first-contact provider.
Most of the cost differences were because of higher inpatient payments for such cases. Analysis of recurrent episodes indicates that chiropractic providers retain more patients for subsequent episodes and that patient exposure to a different provider type during early episodes significantly affects retention rates for later episodes. Patients choosing chiropractic and medical care were comparable on measures of severity and in lapse time between episodes.
The lower costs for episodes in which chiropractors serve as initial contact providers along with the favorable satisfaction and quality indicators for patients suggest that chiropractic deserves careful consideration in gatekeeper strategies adopted by employers and third-party payers to control health care spending. More research is needed, especially in developing alternative measures of health status and outcomes.