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Table 6

Comparison of health care costs in studies also examining clinical outcomes

Chiropractic careComparator group(s)ComparatorLowestDifferencea
First authorYearHealth care costs included n Costs n Costs
Bronfort [46]2000Office visits, injections7$5501. Medical physician care (i.e. prescriptions NSAIDs, acetaminophen, mild narcotic, activity modification, self-care instruction from a PT)13$1,285Chiropractic−57 %
2. ESI with activity modification and self-care instruction from a PT
Carey [40]1995Outpatient costs (office visits, radiography, other imaging, medication, PT, other treatment)606$6841. Urban medical physician primary careb 1,027$536Comparator28 %
2. Rural medical physician primary careb
3. Orthopedistb
4. HMO provider (i.e. NPs and PAs)
Cherkin [44]1998Office visits, imaging, laboratory tests, medications122$4291. PT care (i.e. exercise, lumbar cushion support, McKenzie book, education)199$343Comparator25 %
2. Educational booklet (i.e. The Back Book)
Haas [41]2005Office visits, advanced imaging, surgical consultation, PT1,855$222Medical physician care (i.e. prescription drugs, exercise, self-care advice, PT referral)925$211Comparator5 %
Kominski [45]2005Outpatient costs (office visits, surgery, injection, other)325$5581. Medical physician care (i.e. back care advice, exercise, bed rest, narcotic analgesics, muscle relaxants, anti-inflammatories, OTC pain relievers)329$616Chiropractic−10 %
2. Medical physician care + physical modalities (i.e. heat, cold, ultrasound, EMS, soft tissue and joint mobilization, mechanical traction, SET)
Sharma [43]2009Office visits, advanced imaging, surgical consultation, PT1,558$220Medical physician care744$205Comparator8 %
Stano [42]2002Office visits, medication, radiography1,524$2141. Medical physician care + referral to surgeon and/or PT739$123Comparator74 %
2. Medical physician care without referral to surgeon or PT
areported as (−(comparator costs - chiropractic care costs)/comparator costs) × 100 %

bno details reported about care received

EMS electrical muscle stimulation, ESI epidural steroid injection, HMO health maintenance organization, NP nurse practitioner, OTC over-the-counter, PA physician assistant, PT physical therapist, SET supervised exercise therapy