OBJECTIVE: To compare the health care costs of patients who have received chiropractic treatment for common neuromusculoskeletal disorders with those treated solely by medical and osteopathic physicians.

DESIGN: Retrospective statistical analysis of 2 yr of claims data on various categories of utilization and insurance payments for a large national sample of patients.

SETTING: Ambulatory and inpatient care.

PATIENTS: A total of 395,641 patients with one or more of 493 neuromusculoskeletal ICD-9 codes.

OUTCOME MEASURES: Hospital admission rates and 10 categories of insurance payments.

RESULTS: Nearly one-fourth of patients were treated by chiropractors. Patients receiving chiropractic care experienced significantly lower health care costs as represented by third party payments in the fee-for-service sector. Total cost differences on the order of $1,000 over the 2-yr period were found in the total sample of patients as well as in subsamples of patients with specific disorders. The lower costs are attributable mainly to lower inpatient utilization. The cost differences remain statistically significant after controlling for patient demographics and insurance plan characteristics.

CONCLUSIONS: Although work is in progress to control for possible variations in case mix and to compare outcomes in addition to costs, these preliminary results suggest a significant cost-saving potential for users of chiropractic care. The results also suggest the need to reexamine insurance practices and programs that restrict chiropractic coverage relative to medical coverage.

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