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Chiropractic Cost-Effectiveness

By |March 16, 2011|Cost-Effectiveness, News|

Chiropractic Cost-Effectiveness

The Chiro.Org Blog


SOURCE:   Health Insights Today

By Daniel Redwood, DC


“Doctors of chiropractic are a vital part of our nation’s health care system. Your services have been proven both effective and cost-effective and every day you help countless Americans with a variety of health conditions.”

~ Kathleen Sebelius,
Secretary of Health and Human Services
2011 National Chiropractic Legislative Conference

Health care costs in the United States continue to rise and now account for 17.6% of the economy. In the public sector, Medicare and Medicaid budgets are under continual strain, while accelerating private sector insurance premium increases are pricing millions of American families out of the market each year.

Aside from outlawing pre-existing condition exclusions and providing premium subsidies for those who need them most, the Patient Protection and Affordable Care Act of 2010 (PPACA) empowers the Department of Health and Human Services to take a variety of steps toward controlling costs. But attempts to utilize these powers will trigger strong opposition from groups facing adverse impact to their bottom lines. Further complicating matters, the future of PPACA remains uncertain as opponents seek to vilify, defund and repeal it. (more…)

Cost-Effectiveness Revisited

By |June 14, 2010|Low Back Pain, Neck Pain, News|

Cost-Effectiveness Revisited

The Chiro.Org Blog


SOURCE:   The Chiropractic Report

David Chapman-Smith, LL.B (Hons)


As the United States faces the prospect of major reform to its healthcare system a dramatic new expert study from leading US health economists from Mercer Health and Benefits, and Harvard University analyses chiropractic management of back and neck pain and reports:

  • “Almost half of US patients with persistent back pain” seek chiropractic care.
  • “Low-back and neck pain are extremely common conditions that consume large amounts of healthcare resources”.
  • Effectiveness: chiropractic care is more effective than other modalities for treating low-back and neck pain”.
  • Cost-effectiveness: when considering effectiveness and cost together, chiropractic physician care for low-back and neck pain is highly cost-effective, and represents a good value in comparison to medical physician care and to widely accepted cost-effectiveness thresholds”. (more…)

The Cost-Effectiveness of Chiropractic

By |April 17, 2009|Cost-Effectiveness|

The Cost-Effectiveness of Chiropractic

The Chiro.Org Blog


John’s recent post on the de-listing of chiropractic generated a lot of interest and comments from DCs, MDs and RMTs.

In the USA, Chiropractic has been included in several managed care programs, and a recent review of 70,274 member-months over a 7-year period within an IPA demonstrated:

  • decreases of 60.2% in-hospital admissions,
  • 59.0% less hospital days,
  • 62.0% less outpatient surgeries and procedures, and
  • 83% less pharmaceutical costs when patients were seen by a DC rather than an MD for the same complaint!

The authors concluded that:

“this clearly demonstrates that chiropractic nonsurgical nonpharmaceutical approaches generates reductions in both clinical and cost utilization when compared with PCPs using conventional medicine alone.”

So, Alberta, Canada may save some money that won’t be paid to the chiropractors, but inevitably will lose much more money in the long run.

The Cost-Effectiveness of Chiropractic Page contains many more prospective studies going back to 1985 that demonstrate the cost savings associated with chiropractic care.

There’s a lot more like this in our LINKS Seection

Maternal Report of Outcomes of Chiropractic Care for Infants

By |July 2, 2019|Patient Satisfaction, Pediatrics|

Maternal Report of Outcomes of Chiropractic Care for Infants

The Chiro.Org Blog


SOURCE:   J Manipulative Physiol Ther. 2019 (Mar; 42 (3): 167–176

Joyce E. Miller, DC, PhD, Heather A. Hanson, DC, MSc, Mandy Hiew, BA, Derek S. Lo Tiap Kwong, BA, Zicheng Mok, BA, Yun-Han Tee, BA

Outpatient Teaching Clinic,
AECC University College,
Bournemouth, Dorset, UK.


OBJECTIVE:   The purpose of this study was to investigate the report by mothers of their infants’ condition before and after a trial of care provided by registered chiropractic clinicians in addition to ratings of satisfaction, cost of care, and reports of any adverse events or side effects. A second purpose was to report the demographic profile of infants who presented for care to 16 chiropractic clinics in the United Kingdom.

METHODS:   This observational study prospectively collected reports by mothers of their infants’ demographic profiles and outcomes across several domains of infant behavior and their own mental state using the United Kingdom Infant Questionnaire. Participating registered chiropractors were recruited through the Royal College of Chiropractors annual meeting in January 2016, and 15 clinics and the Anglo-European College of Chiropractic University College teaching clinic volunteered to participate.

RESULTS:   In all, 2001 mothers completed intake questionnaires and 1092 completed follow-up forms. Statistically significant (P < .05) improvements were reported across all aspects of infant behavior studied, including feeding problems, sleep issues, excessive crying, problems with supine sleep position, infant pain, restricted cervical range of motion, and time performing prone positioning. Maternal ratings of depression, anxiety, and satisfaction with motherhood also demonstrated statistically significant improvement (P < .05). In total, 82% (n = 797) reported definite improvement of their infants on a global impression of change scale. As well, 95% (n = 475) reported feeling that the care was cost-effective, and 90.9% (n = 712) rated their satisfaction 8 or higher on an 11–point scale. Minor self-limiting side effects were reported (5.8%, n = 42/727) but no adverse events.

There are more articles like this @ our:

PEDIATRICS Section

(more…)

Patient-reported Improvements of Pain, Disability, and Health-related Quality of Life Following Chiropractic Care for Back Pain

By |May 20, 2019|Spinal Pain|

Patient-reported Improvements of Pain, Disability, and Health-related Quality of Life Following Chiropractic Care for Back Pain – A National Observational Study in Sweden

The Chiro.Org Blog


SOURCE:   J Bodyw Mov Ther. 2019 (Apr);   23 (2):   241–246

Gedin F, MSc; Dansk V, MSc; Egmar A-C, PhD; Sundberg T, PhD; Burström K, PhD

Health Economics and Economic Evaluation Research Group,
Medical Management Centre,
Karolinska Institutet,
Stockholm, Sweden


BACKGROUND:   Chiropractic care is a common but not often investigated treatment option for back pain in Sweden. The aim of this study was to explore patient-reported outcomes (PRO) for patients with back pain seeking chiropractic care in Sweden.

METHODS:   Prospective observational study. Patients 18 years and older, with non-specific back pain of any duration, seeking care at 23 chiropractic clinics throughout Sweden were invited to answer PRO questionnaires at baseline with the main follow-up after four weeks targeting the following outcomes: Numerical Rating Scale for back pain intensity (NRS), Oswestry Disability Index for back pain disability (ODI), health-related quality of life (EQ-5D index) and a visual analogue scale for self-rated health (EQ VAS).

RESULTS:   246 back pain patients answered baseline questionnaires and 138 (56%) completed follow-up after four weeks. Statistically significant improvements over the four weeks were reported for all PRO by acute back pain patients (n = 81), mean change scores: NRS -2.98 (p < 0.001), ODI -13.58 (p < 0.001), EQ VAS 9.63 (p < 0.001), EQ-5D index 0.22 (p < 0.001); and for three out of four PRO for patients with chronic back pain (n = 57), mean change scores: NRS -0.90 (p = 0.002), ODI -2.88 (p = 0.010), EQ VAS 3.77 (p = 0.164), EQ-5D index 0.04 (p = 0.022).

There are more articles like this @ our:

SPINAL PAIN MANAGEMENT Page

(more…)

Change in Young People’s Spine Pain Following Chiropractic Care at a Publicly Funded Healthcare Facility in Canada

By |May 7, 2019|Pediatrics, Spinal Pain|

Change in Young People’s Spine Pain Following Chiropractic Care at a Publicly Funded Healthcare Facility in Canada

The Chiro.Org Blog


SOURCE:   Complement Ther Clin Pract. 2019 (May); 35: 301–307

Christian Manansala, DC, MSc(c), Steven Passmore, DC, PhD, Katie Pohlman, DC, PhD(c), Audrey Toth, DC, Gerald Olin, BSc, DC, CDir

Faculty of Kinesiology and Recreation Management,
University of Manitoba, Canada.



BACKGROUND:   The presence of spinal pain in young people has been established as a risk factor for spinal pain later in life. Recent clinical practice guidelines recommend spinal manipulation (SM), soft tissue therapy, acupuncture, and other modalities that are common treatments provided by chiropractors, as interventions for spine pain. Less is known specifically on the response to chiropractic management in young people with spinal pain. The purpose of this manuscript was to describe the impact, through pain measures, of a pragmatic course of chiropractic management in young people’s spinal pain at a publicly funded healthcare facility for a low-income population.

METHODS:   The study utilized a retrospective analysis of prospectively collected quality assurance data attained from the Mount Carmel Clinic (MCC) chiropractic program database. Formal permission to conduct the analysis of the database was acquired from the officer of records at the MCC. The University of Manitoba’s Health Research Ethics Board approved all procedures.

RESULTS:   Young people (defined as 10-24 years of age) demonstrated statistically and clinically significant improvement on the numeric rating scale (NRS) in all four spinal regions following chiropractic management.

There are more articles like this @ our:

CHIROPRACTIC PEDIATRICS Page

(more…)

Spinal Manipulation and Exercise for Low Back Pain in Adolescents

By |March 22, 2019|Exercise and Chiropractic|

Spinal Manipulation and Exercise for Low Back Pain in Adolescents: A Randomized Trial

The Chiro.Org Blog


SOURCE:   Pain. 2018 (Jul); 159 (7): 1297–1307

Roni Evans, Mitchell Haas, Craig Schulz, Brent Leininger, Linda Hanson, and Gert Bronfort

Integrative Health & Wellbeing Research Program,
Earl E. Bakken Center for Spirituality and Healing,
University of Minnesota,
Minneapolis, MN, USA.



Low back pain (LBP) is common in adolescence, but there is a paucity of high-quality research to inform care. We conducted a multicenter randomized trial comparing 12 weeks of spinal manipulative therapy (SMT) combined with exercise therapy (ET) to ET alone.

Participants were 185 adolescents aged 12 to 18 years with chronic LBP.

The primary outcome was LBP severity at 12, 26, and 52 weeks. Secondary outcomes included disability, quality of life, medication use, patient- and caregiver-rated improvement, and satisfaction. Outcomes were analyzed using longitudinal linear mixed effect models. An omnibus test assessing differences in individual outcomes over the entire year controlled for multiplicity.

Of the 185 enrolled patients, 179 (97%) provided data at 12 weeks and 174 (94%) at 26 and 52 weeks. Adding SMT to ET resulted in a larger reduction in LBP severity over the course of 1 year (P = 0.007). The group difference in LBP severity (0–10 scale) was small at the end of treatment (mean difference = 0.5; P = 0.08) but was larger at weeks 26 (mean difference = 1.1; P = 0.001) and 52 (mean difference = 0.8; P = 0.009). At 26 weeks, SMT with ET performed better than ET alone for disability (P = 0.04) and improvement (P = 0.02). The SMT with ET group reported significantly greater satisfaction with care at all time points (P ≤ 0.02). There were no serious treatment-related adverse events.

There are more articles like this @ our:

Chiropractic Pediatrics Section

(more…)

Managing Sickness Absence of Patients with Musculoskeletal Pain

By |January 19, 2019|Return To Work, Workers' Compensation|

Managing Sickness Absence of Patients with Musculoskeletal Pain – A Cross-sectional Survey of Scandinavian Chiropractors

The Chiro.Org Blog


SOURCE:   Chiropractic & Manual Therapies 2019 (Jan 11); 27: 1

Mette Jensen Stochkendahl, Casper Glissmann Nim, Eleanor Boyle, Ole Kristoffer Larsen, Iben Axén, Ole Christian Kvammen and Corrie Myburgh

Nordic Institute of Chiropractic and Clinical Biomechanics,
Campusvej 55, DK-5230
Odense M, Denmark.



BACKGROUND:   Musculoskeletal pain is a major cause of work disability. Many patients with musculoskeletal pain seek care from health care providers other than their general practitioners, including a range of musculoskeletal practitioners. Therefore, these musculoskeletal practitioners may play a key role by engaging in sickness absence management and work disability prevention. This study aimed to determine the prevalence of musculoskeletal practitioners’ practice behaviours, and their perceptions and beliefs about sickness absence management by using Scandinavian chiropractors as an example, as well as to examine the association between these characteristics and two different practice behaviours.

METHODS:   As part of a mixed-methods study, we surveyed members of the national chiropractic associations in Denmark, Norway, and Sweden in 2016. Descriptive statistics were used to describe prevalence. Multilevel logistic regression with backwards stepping was used to estimate odds ratios with 95% confidence intervals between each of the two practice behaviours and the characteristics.

RESULTS:   Out of the 802 respondents (response rate 56%), 372 were Danish, 349 Norwegian, and 81 Swedish. In Denmark and Norway, 38.7 and 37.8% always/often considered if sick leave was appropriate for their patient compared to 21.0% in Sweden (p = 0.007); and 86.5% of the Norwegian chiropractors always/often recommended to return-to-work versus 64.5 and 66.7% in Denmark and Sweden respectively (p < 0.001). In the final models, factors associated with the two practice behaviours were age, level of clinical experience, working as a teacher, the tendency to be updated on current legislations and policies using social services, contact with general practitioners, relevance of engagement in SAM, consideration of workplace factors, SAM as part of the clinical tool box, patient out-of-pocket fee, and recommending fast return-to-work.

There are more articles like this @ our:

WORKERS’ COMPENSATION Page

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Importance of the Type of Provider Seen to Begin Health Care for a New Episode Low Back Pain

By |August 11, 2018|Cost-Effectiveness of Chiropractic|

Importance of the Type of Provider Seen to Begin Health Care for a New Episode Low Back Pain: Associations with Future Utilization and Costs

The Chiro.Org Blog


SOURCE:   J Eval Clin Pract. 2016 (Apr); 22 (2): 247–252

Julie M. Fritz PhD PT FAPTA, Jaewhan Kim PhD, and Josette Dorius BSN MPH

Department of Physical Therapy,
College of Health,
University of Utah,
Salt Lake City, UT, USA.


Editorial Comment


This article is the perfect example of how mis-leading an Abstract can be, when it fails to reflect what the study actually reveals.
(see it below)

The RESULTS portion of this Abstract only partially discusses the findings, comparing 3 different professions’ treatment, costs, and outcomes for low back pain.

In it they only mention the costs associated with medical management, while in reviewing chiropractic care vs. physical thereapy portions, they choose to emphasize:

Entry in chiropractic was associated with
an increased episode of care duration

whereas

Entry in physical therapy
no patient entering in physical therapy had surgery.

That *seems* to suggest that physical therapy *may* entail less expense, or shorter durations of care, or that chiropractic patients are more likely to end up with surgery.   None of that is true.   Their own Table 2 plainly reveals that chiropractic care was the least expensive form of care provided to the 3 groups.

There are more articles like this @ our:

The Cost-Effectiveness of Chiropractic Page

(more…)