The 130th Annual Meeting of APHA

Abstract #43082

William G Johnson, PhD, School of Health Administration and Policy and Department of Economics, Arizona State University, Box 874506, Tempe, AZ 85287-4506, Marjorie L. Baldwin, PhD, Department of Economics, East Carolina University, Brewster A-427, Tenth Street, Greenville, NC 27858-4353, 252-328-6383, william.g.johnson@asu.edu, and Pierre Côté, DC, PhD, Institute for Work and Health, University of Toronto, #702-250 Bloor Street East, Toronto, ON M4W 3E6, Canada.

Back pain is the single most common and costly work-related injury. There has been extensive research to identify appropriate ways to manage work-related back pain. Most studies of patterns and costs of back pain focus on only one dimension of the question. This study compares the relative cost-effectiveness of chiropractic vs. physician care for occupational back pain. Patterns of health care, worker characteristics, employer interventions and economic incentives are integrated in the most comprehensive study on the treatment of work-related back pain. The study combines longitudinal survey data with claims data from employers’ workers’ compensation files to analyze the effects of treatment provided by chiropractors and physicians.

Six national employers, with an employee base of nearly 210,000 workers, participated in the three-year cohort study. Injured workers were interviewed periodically over the course of one year following their injury. Interview questions included pain intensity and functional status, health-related quality of life, health care, job satisfaction and return-to-work. Data include medical only and indemnity claims for workers suffering back injuries during the study period.

We estimate the distribution of patients by type of provider, and the relative effectiveness of treatment from chiropractors versus physicians. We also compare satisfaction of care across provider types. Multivariate models incorporating health and non-health characteristics are used to estimate total costs of care and durations of work absence. Results will benefit employers in returning injured workers to their jobs more quickly without endangering the workers’ permanent recovery.

Learning Objectives:

• § Identify the most cost-effective patterns of health care for chiropractic versus physician care for occupational back pain
• § Identify the characteristics of workers associated with better recovery profiles and post-injury employment experiences following a work-related back injury
• § Analyze the impact of employer interventions, including job accommodations, return-to-work programs, and disability management strategies, on the costs and health outcomes of work-related back pain

Keywords: Chiropractic, Medical Care

Related Web page: www.cob.asu.edu/hap/hap_back_Study_home.cfm

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.