The 130th Annual Meeting of APHA

3017.0: Monday, November 11, 2002 - 8:40 AM

Abstract #40109

Cost-effectiveness of chiropractic and medical care for acute and chronic low back pain

Rajiv L Sharma, PhD, Department of Economics, Portland State University, P.O. Box 751, Portland, OR 97207, 503-725-3933,, Miron Stano, PhD, Department of Economics, Oakland University, School of Business Administration, Rochester, MI 48309, and Mitchell Haas, DC, MA, Division of Research, Western States Chiropractic College, 2900 NE 132nd Ave., Portland, OR 97230.

Information from a prospective, longitudinal, non-randomized, practice-based observational study of 3,000 patients self-referring to medical and chiropractic physicians is used to identify salient determinants of resource use and of improvements in health for patients with low back pain. Patients are tracked for up to three years after they first sought care. Preliminary analysis indicates that most of the decrease in pain and improvement in functional ability occurred within the first two weeks of initial treatment. Patients with more severe baseline pain had larger reductions in pain. Similarly, those with greater baseline functional disability had larger improvements in functionality. A large portion of overall resource use for many patients also occurred within the first two weeks after initial treatment. Those who showed little improvement in pain or in functional ability during the first two weeks used more health care resources than patients who showed more substantial improvements. This phenomenon, i.e., patients who do not respond well to treatment tend to be high users of care, helps explain why there appears to be little positive association between overall health care utilization and outcomes for a population of low back pain patients. The study also examines the relative cost-effectiveness of chiropractic and medical care for acute and chronic patients over extended periods.

Learning Objectives: At the end of this session, the participant will be able to

Keywords: Cost Issues, Economic Analysis

Presenting author's disclosure statement:
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.

Chiropractic Care of Pain: Costs and Outcomes

The 130th Annual Meeting of APHA