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Table 8

Adjusted vs. unadjusted cost comparisons

Unadjusted health care costsComparator groups(s)Adjusted health care costs
First authorYearRisk adjustment variablesChiropracticComparatorLowestChiropracticComparatorLowestComments
Butler [39]2010Physical function, back pain severity, leg pain severity$8681. MD care, 2 MD care + chiropractic care +/− PT care, 3. MD care + PT care, 4. Other$264Comparator$6,984$8,108Chiropractic
Carey [40]1995Physical function, sciatica, income, duration of pain, worker’s compensation$6841. Urban medical physician primary carea $536Comparator$699$523Comparator
2. Rural medical physician primary carea
3. Orthopedista
4. HMO provider (i.e. NPs and PAs)
Haas [41]2005Health insurance, marital status, income$222Medical physician care (i.e. prescription drugs, exercise, self-care advice, PT referral)$211ComparatorN/AN/AComparatorAdjusted costs were $14 higher for chiropractic care
Kominski [45]2005Demographics, physical function, pain, copayments$5581. Medical physician care (i.e. back care advice, exercise, bed rest, narcotic analgesics, muscle relaxants, anti-inflammatories, OTC pain relievers)$616Chiropractic$570$567Comparator
2. Medical physician care + physical modalities (i.e. heat, cold, ultrasound, EMS, soft tissue and joint mobilization, mechanical traction, SET)
Liliedahl [32]2010Symmetry Pharmacy Risk Groups (pharmacy claims, age, and sex)$756MD care$1,037Chiropractic$533$661Chiropractic
Shekelle [31]1995Sociodemographics, health status, attitude, insurance status, location$2641. MD primary care, 2. orthopedist, 3. internist, 4. DO, 5. other providers$166ComparatorN/AN/AComparatorAdjusting changed estimates by $13 but did not change rank order of costs
Stano [28]1996SysteMetrics classification$518MD care$1,020ChiropracticN/AN/AChiropracticRisk adjusting did not change differences between groups
Stano [23]1995SysteMetrics classification, age, sex, location, employee/dependent, insurance type, coinsurance, deductible, type of chiropractic coverage$493MD care$1,000Chiropractic$508$542Chiropractic
Stano [24]1994Age, sex, region, work status, employee/dependent, health plan type$5,474MD care$8,427ChiropracticN/AN/AChiropracticAdjusted costs were $1,197 lower for chiropractic care
Stano [22]1993Age, sex, location, employee/dependent, work status, coinsurance, deductible, health plan coverage of chiropractic$2,150MD care$3,127ChiropracticN/AN/AChiropracticAdjusted costs were 27 % lower for chiropractic care
ano details reported about care received

DO doctor of osteopathy, EMS electrical muscle stimulation, HMO health maintenance organization, MD medical doctor, N/A not applicable, NP nurse practitioner, OTC over-the-counter, PA physician assistant, PT physical therapist, SET supervised exercise therapy