This study describes and evaluates utilization, cost, and outcomes measures derived from the federally funded Oregon Low-Back Pain Study. Nearly 3000 ambulatory patients with acute or chronic low-back conditions entered this prospective study in 1995 or 1996 after visiting either 111 general medical physicians or 60 chiropractors situated mainly in the Portland area. Comparable relative value units (RVUs) are developed for the two groups of patients to measure utilization. Costs are expressed through Medicare equivalent payments and are determined by multiplying the RVUs by Medicare's 1995 conversion factor. All services including prescription and over-the-counter drugs are captured in the study. Low back pain (VAS) and functional disability (revised Oswestry) were the primary outcomes. Other important outcomes included patient satisfaction and general health status (SF-36D/SF-12D). The pain survey instruments were administered at baseline and at varying intervals up to one year. Utilization and costs were cumulated over each of these intervals. We provide results from descriptive and univariate analyses but focus more on those derived from multivariate statistical models. The latter are used to determine the relationships between medical and chiropractic treatments and the outcomes measures while controlling for the duration of the patient's condition, comorbidities and other clinical and socioeconomic factors. By estimating the productivity of medical and chiropractic care in comparable units and over varying intervals, we provide new evidence on their relative economic effectiveness in managing patients with low-back pain.
Learning Objectives: At the end of this session, the participant will be able to: 1. Recognize the economic concept of a production function of health. 2. Evaluate relationships between health care inputs and various measures of health. 3. Describe and discuss results relating to the relative productivity of chiropractic and medical services to the production of health
Keywords: Cost Issues, Economic Analysis
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.