An Evaluation of Medical and Chiropractic Provider Utilization and Costs: Treating Injured Workers in North Carolina

Phelan, Shawn P.; Armstrong, Richard C.; Knox, David G.; Hubka, Michael J.; Ainbinder, Dennis A.

doi:10.1016/j.jmpt.2004.06.002

Cited by 8 publications

(11 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Phelan et al [80] look at utilization and costs for treating injured workers in North Carolina. The study examined, in addition to utilization and treatment cost, lost work days and compensation paid to those with MS injuries who treated either by an MD or a DC.…”

Section: Resultsmentioning

confidence: 99%

Chiropractic and CAM Utilization: A Descriptive Review

Lawrence

Meeker

2007

Chiropr Man Therap

View full text Add to dashboard Cite

Objective: To conduct a descriptive review of the scientific literature examining use rates of modalities and procedures used by CAM clinicians to manage chronic LBP and other conditions Data Selection: A total of 137 papers were selected, based upon including information about chiropractic utilization, CAM utilization and low back pain and other conditions. Data Synthesis: Information was extracted from each paper addressing use of chiropractic and CAM, and is summarized in tabular form.Results: Thematic analysis of the paper topics indicated that there were 5 functional areas covered by the literature: back pain papers, general chiropractic papers, insurance-related papers, general CAM-related papers; and worker's compensation papers. Conclusion:Studies looking at chiropractic utilization demonstrate that the rates vary, but generally fall into a range from around 6% to 12% of the population, most of whom seek chiropractic care for low back pain and not for organic disease or visceral dysfunction. CAM is itself used by people suffering from a variety of conditions, though it is often used not as a primary intervention, but rather as an additional form of care. CAM and chiropractic often offer lower costs for comparable results compared to conventional medicine.

show abstract

Section: Resultsmentioning

confidence: 99%

Chiropractic and CAM Utilization: A Descriptive Review

Lawrence

Meeker

2007

Chiropr Man Therap

View full text Add to dashboard Cite

show abstract

“…Spinal manipulation (SM) is a therapeutic tool used by several health care professions [ 1 ]. It is reasonably inexpensive [ 2 ] and recognized to have a clinically significant impact on musculoskeletal pain [ 3 ]. Nevertheless, its indications and mechanisms of action are still not well established for example in relation to pain reduction.…”

Section: Introductionmentioning

confidence: 99%

The regional effect of spinal manipulation on the pressure pain threshold in asymptomatic subjects: a systematic literature review

2018

View full text Add to dashboard Cite

BackgroundSpinal manipulation (SM) has been shown to have an effect on pain perception. More knowledge is needed on this phenomenon and it would be relevant to study its effect in asymptomatic subjects.ObjectivesTo compare regional effect of SM on pressure pain threshold (PPT) vs. sham, inactive control, mobilisation, another SM, and some type of physical therapy. In addition, we reported the results for the three different spinal regions.MethodA systematic search of literature was done using PubMed, Embase and Cochrane. Search terms were ((spinal manipulation) AND (experimental pain)); ((spinal manipulative therapy OR spinal manipulation) AND ((experimental pain OR quantitative sensory testing OR pressure pain threshold OR pain threshold)) (Final search: June 13th 2017). The inclusion criteria were SM performed anywhere in the spine; the use of PPT, PPT tested in an asymptomatic region and on the same day as the SM. Studies had to be experimental with at least one external or internal control group. Studies on only spinal motion or tenderness, other reviews, case reports, and less than 15 invited participants in each group were excluded. Evidence tables were constructed with information relevant to each research question and by spinal region. Results were reported in relation to statistical significance and were interpreted taking into account their quality.ResultsOnly 12 articles of 946 were accepted. The quality of studies was generally good. In 8 sham controlled studies, a psychologically and physiologically “credible” sham was found in only 2 studies. A significant difference was noted between SM vs. Sham, and between SM and an inactive control. No significant difference in PPT was found between SM and another SM, mobilisation or some type of physical therapy. The cervical region more often obtained significant findings as compared to studies in the thoracic or lumbar regions.ConclusionSM has an effect regionally on pressure pain threshold in asymptomatic subjects. The clinical significance of this must be quantified. More knowledge is needed in relation to the comparison of different spinal regions and different types of interventions.

show abstract

“…Received care from PT and DC; 5. Permanent total disability cases NR/844/844 Phelan [ 36 ] 2004 North Carolina /Various payers Claims/North Carolina Industrial Commission 1/1/1975 - 12/31/1994 Lumbar or lumbosacral strain/Any 1. Closed injury claims, and 2.…”

Section: Resultsmentioning

confidence: 99%

“…Other maintenance care, 5. No maintenance care 735 b $566 Chiropractic −27 % Gilkey [ 35 ] 2008 Not specified 76 $868 MD care 2,380 $264 Comparator 229 % Jarvis [ 38 ] 1997 All health care costs associated with claim 1,007 $596 MD care 2,279 $658 Chiropractic −9 % Johnson [ 34 ] 1999 Office visits, PT, imaging, other diagnostic testing, medications, hospital visits 173 $1,044 MD care 671 $1,075 Chiropractic −3 % Phelan [ 36 ] 2004 Office visits to DC/MD/PT, medications, hospital inpatient, hospital outpatient, supplies 181 $685 1. MD care, 2.…”

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

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

Dagenais

Brady

Haldeman

et al. 2015

BMC Health Serv Res

View full text Add to dashboard Cite

BackgroundAlthough chiropractors in the United States (US) have long suggested that their approach to managing spine pain is less costly than other health care providers (HCPs), it is unclear if available evidence supports this premise.MethodsA systematic review was conducted using a comprehensive search strategy to uncover studies that compared health care costs for patients with any type of spine pain who received chiropractic care or care from other HCPs. Only studies conducted in the US and published in English between 1993 and 2015 were included. Health care costs were summarized for studies examining: 1. private health plans, 2. workers’ compensation (WC) plans, and 3. clinical outcomes. The quality of studies in the latter group was evaluated using a Consensus on Health Economic Criteria (CHEC) list.ResultsThe search uncovered 1276 citations and 25 eligible studies, including 12 from private health plans, 6 from WC plans, and 7 that examined clinical outcomes. Chiropractic care was most commonly compared to care from a medical physician, with few details about the care received. Heterogeneity was noted among studies in patient selection, definition of spine pain, scope of costs compared, study duration, and methods to estimate costs. Overall, cost comparison studies from private health plans and WC plans reported that health care costs were lower with chiropractic care. In studies that also examined clinical outcomes, there were few differences in efficacy between groups, and health care costs were higher for those receiving chiropractic care. The effects of adjusting for differences in sociodemographic, clinical, or other factors between study groups were unclear.ConclusionsAlthough cost comparison studies suggest that health care costs were generally lower among patients whose spine pain was managed with chiropractic care, the studies reviewed had many methodological limitations. Better research is needed to determine if these differences in health care costs were attributable to the type of HCP managing their care.Electronic supplementary materialThe online version of this article (doi:10.1186/s12913-015-1140-5) contains supplementary material, which is available to authorized users.

show abstract

An Evaluation of Medical and Chiropractic Provider Utilization and Costs: Treating Injured Workers in North Carolina

Cited by 8 publications

References 14 publications

Chiropractic and CAM Utilization: A Descriptive Review

Chiropractic and CAM Utilization: A Descriptive Review

The regional effect of spinal manipulation on the pressure pain threshold in asymptomatic subjects: a systematic literature review

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

Contact Info

Product

Resources

About