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Craig F Nelson, MS, DC and Kurt Hegetschweiler, DC. Health Services Research, American Specialty Health, 777 Front St., San Diego, CA 92101, 619-405-3658, cnelson19@mn.rr.com
Background: The evidence indicates that procedures and practices such as in-patient care, advanced imaging, surgery, and plain film radiographs are only infrequently necessary for the successful treatment of most cases of low back pain and neck pain.
Objective: To evaluate the effects of a chiropractic benefit on the rates of utilization of high cost and invasive procedures for the treatment of low back pain and neck pain.
Methods: A retrospective analysis of claims data from a managed care health plan over a four-year period was conducted. Rates of specific diagnostic and therapeutic procedures were compared between groups with and without chiropractic coverage.
Results: On a per episode basis the rates in the group with coverage were reduced by the following: surgery (-32%); CT/MRI use (-38%); plain film radiography (-23%); in-patient care (-41%). On a per patient basis the rates were reduced by the following: surgery (-14%); CT/MRI (-21%); plain film radiography (-3%); in-patient care (-24%).
For neck pain patients the utilization rates were reduced in the group with chiropractic coverage were as follows: Per episode: surgery (-49%); CT/MRI (-47%); plain film radiography (-34%); in-patient care (-49%). Per patient: surgery (-31%); CT/MRI (-26%); plain film radiography (-12%); in-patient care (39%). All group differences were statistically significant.
Conclusion: Among employer groups with chiropractic coverage compared to those without such coverage, there is a significant reduction in the utilization of high cost and invasive procedures.
Learning Objectives:
Keywords: Chiropractic, Managed Care
Presenting author's disclosure statement:
I have a significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.
Relationship: I am employed by the health plan that is the subject of this study.