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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

The Use of Complementary and Integrative Health Approaches for Chronic Musculoskeletal Pain in Younger US Veterans: An Economic Evaluation

By |March 25, 2020|Alternative Medicine, Cost-Effectiveness of Chiropractic|

The Use of Complementary and Integrative Health Approaches for Chronic Musculoskeletal Pain in Younger US Veterans: An Economic Evaluation

The Chiro.Org Blog


SOURCE:   PLoS One. 2019 (Jun 5); 14 (6): e0217831

Valerie F. Williams, MA, MS; Leslie L. Clark, PhD, MS; Mark G. McNellis, PhD

RAND Corporation,
Santa Monica, California,
United States of America.



OBJECTIVES:   To estimate the cost-effectiveness to the US Veterans Health Administration (VA) of the use of complementary and integrative health (CIH) approaches by younger Veterans with chronic musculoskeletal disorder (MSD) pain.

PERSPECTIVE:   VA healthcare system.

METHODS:   We used a propensity score-adjusted hierarchical linear modeling (HLM), and 2010-2013 VA administrative data to estimate differences in VA healthcare costs, pain intensity (0-10 numerical rating scale), and opioid use between CIH users and nonusers. We identified CIH use in Veterans’ medical records through Current Procedural Terminology, VA workload tracking, and provider-type codes.

There are more articles like this @ our:

Chiropractic Care For Veterans Page

(more…)

Impact of Chiropractic Care on Use of Prescription Opioids in Patients with Spinal Pain

By |March 14, 2020|Spinal Pain|

Impact of Chiropractic Care on Use of Prescription Opioids in Patients with Spinal Pain

The Chiro.Org Blog


SOURCE:   Pain Med. 2020 (Mar 6) [Epub]

James M. Whedon, DC, MS, Andrew W. J. Toler, MS, Louis A. Kazal, MD, Serena Bezdjian, PhD, Justin M. Goehl, DC, MS et al.

Southern California University of Health Sciences,
Whittier, California.


OBJECTIVE:   Utilization of nonpharmacological pain management may prevent unnecessary use of opioids. Our objective was to evaluate the impact of chiropractic utilization upon use of prescription opioids among patients with spinal pain.

DESIGN AND SETTING:   We employed a retrospective cohort design for analysis of health claims data from three contiguous states for the years 2012-2017.

SUBJECTS:   We included adults aged 18-84 years enrolled in a health plan and with office visits to a primary care physician or chiropractor for spinal pain. We identified two cohorts of subjects: Recipients received both primary care and chiropractic care, and nonrecipients received primary care but not chiropractic care.

METHODS:   We performed adjusted time-to-event analyses to compare recipients and nonrecipients with regard to the risk of filling an opioid prescription. We stratified the recipient populations as: acute (first chiropractic encounter within 30 days of diagnosis) and nonacute (all other patients).

There are more articles like this @ our:

SPINAL PAIN MANAGEMENT Page

(more…)

Treatment of Patients with Low Back Pain: A Comparison of Physical Therapy and Chiropractic Manipulation

By |March 5, 2020|Cost-Effectiveness of Chiropractic|

Treatment of Patients with Low Back Pain: A Comparison of Physical Therapy and Chiropractic Manipulation

The Chiro.Org Blog


SOURCE:   Healthcare (Basel). 2020 (Feb 24); 8 (1): E44

Nima Khodakarami

Department of Health Policy and Management,
Texas A&M University,
College Station, TX 77843, USA.



Low back pain (LBP) is a pandemic and costly musculoskeletal condition in the United States (U.S.). Patients with LBP may endure surgery, injections, and expensive visits to emergency departments. Some suggest that using physical therapy (PT) or chiropractic in the earlier stage of LBP reduces the utilization of expensive health services and lowers the treatment costs. Given that there are costs and benefits with each of these treatments, the remaining question is in a short period of time which of these treatments is optimal. The purpose of this study was to investigate the cost-effectiveness of chiropractic versus PT in the U.S. A decision tree analytic model was used for estimating the economic outcomes. The findings showed that the total average cost in the chiropractic group was $48.56 lower than the PT group. The findings also showed that the daily adjusted life years (DALY) in the chiropractic group was 0.0043 higher than the PT group. Chiropractic care was shown to be a cost-effective alternative compared with PT for adults with at least three weeks of LBP over six months.

KEYWORDS:   Keywords: chiropractic; physical therapy; treatment outcome; low back pain; therapy; economics; patient satisfaction; recurrence; health care costs; illness

There are more articles like this @ our:

Cost-Effectiveness of Chiropractic Page

(more…)

Cost-Efficiency and Effectiveness of Including Doctors of Chiropractic to Offer Treatment Under Medicaid

By |January 7, 2020|Cost-Effectiveness|

Cost-Efficiency and Effectiveness of Including Doctors of Chiropractic to Offer Treatment Under Medicaid:
A Critical Appraisal of Missouri Inclusion of Chiropractic Under Missouri Medicaid

The Chiro.Org Blog


SOURCE:   Journal of Chiropractic Humanities 2019 (Dec 10)

John R. McGowan, PhD, Leonard Suiter, DC, FICC

Department of Accounting,
Richard A. Chaifetz School of Business,
Saint Louis University,
St. Louis, Missouri


OBJECTIVES:   The objectives of this study were to critically evaluate the methodology and conclusions of the fiscal notes prepared by the state of Missouri for including doctors of chiropractic (DCs) under Missouri Medicaid and to develop a dynamic scoring model that calculates the savings if DCs were allowed to offer treatment under Missouri Medicaid.

METHODS:   We used a secondary analysis to determine the cost-saving assumptions to be incorporated into a dynamic model. We reviewed the literature on efficiency and effectiveness of DC–delivered care regarding the most reliable assumptions concerning cost savings and utilization. The assumptions for percentage savings from DC–provided care and the avoidance of spinal surgeries were then combined in the dynamic scoring model to determine projected cost savings from adding DCs as covered providers under Missouri Medicaid. The actual cost of opioid abuse in Missouri was then determined as a basis to measure cost savings from adding DC care as an alternative therapy for the management of neck and low back pain.

DISCUSSION:   The Missouri Health Division initially used the static scoring approach to evaluate proposals to cover DC care under Missouri Medicaid. This approach only considers added costs from a legislative change.

There are more articles like this @ our:

Cost-Effectiveness Page and the:

Medicare Information Page

(more…)

The Effect of Spinal Manipulation on Brain Neurometabolites in Chronic Nonspecific Low Back Pain Patients

By |December 3, 2019|Low Back Pain, Neurology|

The Effect of Spinal Manipulation on Brain Neurometabolites in Chronic Nonspecific Low Back Pain Patients: A Randomized Clinical Trial

The Chiro.Org Blog


SOURCE:   Irish Journal of Medical Science 2019 (Nov 26) [Epub]

Daryoush Didehdar, Fahimeh Kamali, Amin Kordi Yoosefinejad, Mehrzad Lotfi

Department of Physical Therapy,
School of Rehabilitation Sciences,
Shiraz University of Medical Sciences,
Shiraz, Iran.



BACKGROUND:   In patients with chronic nonspecific low back pain (NCLBP), brain function changes due to the neuroplastic changes in different regions.

AIM:   The current study aimed to evaluate the brain metabolite changes after spinal manipulation, using proton magnetic resonance spectroscopy (1H-MRS).

METHODS:   In the current study, 25 patients with NCLBP aged 20-50 years were enrolled. Patients were randomly assigned to lumbopelvic manipulation or sham. Patients were evaluated before and 5 weeks after treatment by the Numerical Rating Scale (NRS), the Oswestry Disability Index (ODI), and 1H-MRS.

RESULTS:   After treatment, severity of pain and functional disability were significantly reduced in the treatment group vs. sham group (p < 0.05). After treatment, N-acetyl aspartate (NAA) in thalamus, insula, dorsolateral prefrontal cortex (DLPFC) regions, as well as choline (Cho) in the thalamus, insula, and somatosensory cortex (SSC) regions, had increased significantly in the treatment group compared with the sham group (p < 0.05). A significant increase was further observed in NAA in thalamus, anterior cingulate cortex (ACC), and SCC regions along with Cho metabolite in thalamus and SCC regions after treatment in the treatment group compared with the baseline measures (p < 0.05).

There are more articles like this @ our:

LOW BACK Section

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Chiropractic Maintenance Care – What’s New?
A Systematic Review of the Literature

By |November 22, 2019|Maintenance Care|

Chiropractic Maintenance Care – What’s New?
A Systematic Review of the Literature

The Chiro.Org Blog


SOURCE:   Chiropractic & Osteopathy 2019 (Non 21); 27: 63

Axén Iben, Hestbaek Lise & Leboeuf-Yde Charlotte

Karolinska Institutet,
Institute of Environmental Medicine,
Unit of Intervention and Implementation Research for Worker Health,
Nobels väg 13, 171 77,
Stockholm, Sweden



Background   Maintenance Care is a traditional chiropractic approach, whereby patients continue treatment after optimum benefit is reached. A review conducted in 1996 concluded that evidence behind this therapeutic strategy was lacking, and a second review from 2008 reached the same conclusion. Since then, a systematic research program in the Nordic countries was undertaken to uncover the definition, indications, prevalence of use and beliefs regarding Maintenance Care to make it possible to investigate its clinical usefulness and cost-effectiveness. As a result, an evidence-based clinical study could be performed. It was therefore timely to review the evidence.

Method   Using the search terms “chiropractic OR manual therapy” AND “Maintenance Care OR prevention”, PubMed and Web of Science were searched, and the titles and abstracts reviewed for eligibility, starting from 2007. In addition, a search for “The Nordic Maintenance Care Program” was conducted. Because of the diversity of topics and study designs, a systematic review with narrative reporting was undertaken.

Results   Fourteen original research articles were included in the review. Maintenance Care was defined as a secondary/tertiary preventive approach, recommended to patients with previous pain episodes, who respond well to chiropractic care. Maintenance Care is applied to approximately 30% of Scandinavian chiropractic patients. Both chiropractors and patients believe in the efficacy of Maintenance Care. Four studies investigating the effect of chiropractic Maintenance Care were identified, with disparate results on pain and disability of neck and back pain. However, only one of these studies utilized all the existing evidence when selecting study subjects and found that Maintenance Care patients experienced fewer days with low back pain compared to patients invited to contact their chiropractor ‘when needed’. No studies were found on the cost-effectiveness of Maintenance Care.

There are more articles like this @ our:

MAINTENANCE CARE Page

(more…)