A systematic review comparing the costs of chiropractic care to other interventions for spine pain in the United States

doi:10.1186/s12913-015-1140-5

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BMC Health Serv Res. 2015; 15: 474.

Published online 2015 Oct 19. doi: 10.1186/s12913-015-1140-5

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Table 6

Comparison of health care costs in studies also examining clinical outcomes

			Chiropractic care		Comparator group(s)	Comparator		Lowest	Difference^a
First author	Year	Health care costs included	n	Costs		n	Costs
Bronfort [46]	2000	Office visits, injections	7	$550	1. Medical physician care (i.e. prescriptions NSAIDs, acetaminophen, mild narcotic, activity modification, self-care instruction from a PT)	13	$1,285	Chiropractic	−57 %
Bronfort [46]	2000	Office visits, injections	7	$550	2. ESI with activity modification and self-care instruction from a PT	13	$1,285	Chiropractic	−57 %
Carey [40]	1995	Outpatient costs (office visits, radiography, other imaging, medication, PT, other treatment)	606	$684	1. Urban medical physician primary care^b	1,027	$536	Comparator	28 %
					2. Rural medical physician primary care^b
					3. Orthopedist^b
					4. HMO provider (i.e. NPs and PAs)
Cherkin [44]	1998	Office visits, imaging, laboratory tests, medications	122	$429	1. PT care (i.e. exercise, lumbar cushion support, McKenzie book, education)	199	$343	Comparator	25 %
Cherkin [44]	1998	Office visits, imaging, laboratory tests, medications	122	$429	2. Educational booklet (i.e. The Back Book)	199	$343	Comparator	25 %
Haas [41]	2005	Office visits, advanced imaging, surgical consultation, PT	1,855	$222	Medical physician care (i.e. prescription drugs, exercise, self-care advice, PT referral)	925	$211	Comparator	5 %
Kominski [45]	2005	Outpatient costs (office visits, surgery, injection, other)	325	$558	1. Medical physician care (i.e. back care advice, exercise, bed rest, narcotic analgesics, muscle relaxants, anti-inflammatories, OTC pain relievers)	329	$616	Chiropractic	−10 %
Kominski [45]	2005	Outpatient costs (office visits, surgery, injection, other)	325	$558	2. Medical physician care + physical modalities (i.e. heat, cold, ultrasound, EMS, soft tissue and joint mobilization, mechanical traction, SET)	329	$616	Chiropractic	−10 %
Sharma [43]	2009	Office visits, advanced imaging, surgical consultation, PT	1,558	$220	Medical physician care	744	$205	Comparator	8 %
Stano [42]	2002	Office visits, medication, radiography	1,524	$214	1. Medical physician care + referral to surgeon and/or PT	739	$123	Comparator	74 %
Stano [42]	2002	Office visits, medication, radiography	1,524	$214	2. Medical physician care without referral to surgeon or PT	739	$123	Comparator	74 %

^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