As part of the Department of Defense Chiropractic Health Care Demonstration Project (CHCDP), chiropractic services were provided at three Medical Centers beginning in the fall of 1998. Outpatient data for all active duty patients seeking chiropractic care, and all active duty patients with at least one outpatient visit for back-pain related diagnoses were extracted for the period June 1998 through May 1999, and matched with all inpatient admissions by this patient population. This natural experiment provided data from pre- and post-availability of treatment in a treatment population, and data from pre- and post- availability of treatment in a fixed control population at the same sites over the same time period.
Results of the analysis showed both self-selection and treatment effects in inpatient and outpatient utilization. From the pre- and post-treatment data, patients who selected chiropractic care showed a significant change in inpatient admission rates that varied in direction by site. These same patients used more primary and specialty outpatient care over the study period and less physical therapy and pain management care. As a result the evidence remains mixed on the change in total use of and cost for care of patients selecting chiropractic treatment.
Learning Objectives:
Keywords: Chiropractic, Utilization
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I have a significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.
Relationship: Employed by Birch and Davis Associates, a firm contracted by TRICARE Management Activity, Military Health Services Operations, to evaluate the Chiropractic Health Care Demonstration Project.