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ID | 26431 | ||||||||||||
Title | Cost comparison of two approaches to chiropractic care for patients with acute and sub-acute low back pain care episodes: A cohort study | ||||||||||||
URL | https://chiromt.biomedcentral.com/articles/10.1186/s12998-020-00356-z | ||||||||||||
Journal | Chiropr & Manual Ther. 2020 ;28(68):1-7 | ||||||||||||
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Peer Review | Yes | ||||||||||||
Publication Type | Article | ||||||||||||
Abstract/Notes | Background: Low back pain (LBP) imposes a costly burden upon patients, healthcare insurers, and society overall. Spinal manipulation as practiced by chiropractors has been found be cost-effective for treatment of LBP, but there is wide variation among chiropractors in their approach to clinical care, and the most cost-effective approach to chiropractic care is uncertain. To date, little has been published regarding the cost effectiveness of different approaches to chiropractic care. Thus, the current study presents a cost comparison between chiropractic approaches for patients with acute or subacute care episodes for low back pain. Methods: We employed a retrospective cohort design to examine costs of chiropractic care among patients diagnosed with acute or subacute low back pain. The study time period ranged between 07/01/2016 and 12/22/2017. We compared cost outcomes for patients of two cohorts of chiropractors within health care system: Cohort 1) a general network of providers, and Cohort 2) a network providing conservative evidence-based care for rapid resolution of pain. We used generalized linear regression modeling to estimate the comparative influence of demographic and clinical factors on expenditures. Results: A total of 25,621 unique patients were included in the analyses. The average cost per patient for Cohort 2 (mean allowed amount $252) was lower compared to Cohort 1 (mean allowed amount $326; 0.77, 95% CI 0.75–0.79, p < .001). Patient and clinician related factors such as health plan, provider region, and sex also significantly influenced costs. Conclusions: This study comprehensively analyzed cost data associated with the chiropractic care of adults with acute or sub-acute low back pain cared by two cohorts of chiropractic physicians. In general, providers in Cohort 2 were found to be significantly associated with lower costs for patient care as compared to Cohort 1. Utilization of a clinical model characterized by a patient-centered clinic approach and standardized, best-practice clinical protocols may offer lower cost when compared to non-standardized clinical approaches to chiropractic care. Author keywords: Acute or subacute low back pain — Chiropractic care — Cost comparison — Patient care Author affiliations: JMW, SB, RR: Southern California University of Health Sciences, Whittier, California, United States; PD, V-AF: Fulcrum Health, Inc, Plymouth, Minnesota, United States This abstract is reproduced with the permission of the publisher; click on the above link for free full text. PubMed Record | PDF
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