OBJECTIVE: To review the literature and test a new methodology of assessing chiropractic utilization and cost-effectiveness on workers' compensation claimants.

DESIGN: A retrospective analysis of data from the WorkCover Authority (WCA) of New South Wales, Australia.

MAIN OUTCOME MEASURES: Average chiropractic treatment cost per case, average medical treatment cost per case, comparisons with total compensation payments, assessments of related indirect costs (e.g., pathology tests).

RESULTS: From the total number of employment injuries (n = 51,077) in NSW for 1991-92, 1,289 cases met selection criteria. Approximately 30% of the total injuries were described as back problems. The total utilization rate for chiropractic intervention in spinal injuries for workers' compensation claimants was 12%. Payments for physiotherapy and chiropractic treatment totalled over $25.2 million and represented 2.4% of total payments for all cases. Average chiropractic treatment cost for a sample of 20 randomly selected cases was $299.65; average medical treatment cost per case was $647.20. Further analysis of the 20 selected cases seemed to show an average cost per claim that was significantly different from WCA database figures.

CONCLUSION: The methodology used was found to be able to provide a basis for comparison of costs for care apportioned to chiropractic and other interventions. An analysis of 20 randomly selected cases from the WCA suggested that chiropractic intervention for certain conditions may be more cost-effective than other forms of intervention.

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