Tracking Low Back Problems in a Major Self-Insured Workforce

Allen, Harris; Wright, Marcia; Craig, Terri; Mardekian, Jack; Cheung, Raymond; Sanchez, Robert J.; Bunn, William B.; Rogers, William H.

doi:10.1097/jom.0000000000000210

Cited by 23 publications

(22 citation statements)

References 31 publications

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“…Twelve (48 %) studies examined data from private health plans in the US [ 22 – 33 ]. Six (24 %) studies examined data from worker’s compensation (WC) plans in the US [ 34 – 39 ].…”

Section: Resultsmentioning

confidence: 99%

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A systematic review comparing the costs of chiropractic care to other interventions for spine pain in the United States

Dagenais

Brady

Haldeman

et al. 2015

BMC Health Serv Res

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BackgroundAlthough chiropractors in the United States (US) have long suggested that their approach to managing spine pain is less costly than other health care providers (HCPs), it is unclear if available evidence supports this premise.MethodsA systematic review was conducted using a comprehensive search strategy to uncover studies that compared health care costs for patients with any type of spine pain who received chiropractic care or care from other HCPs. Only studies conducted in the US and published in English between 1993 and 2015 were included. Health care costs were summarized for studies examining: 1. private health plans, 2. workers’ compensation (WC) plans, and 3. clinical outcomes. The quality of studies in the latter group was evaluated using a Consensus on Health Economic Criteria (CHEC) list.ResultsThe search uncovered 1276 citations and 25 eligible studies, including 12 from private health plans, 6 from WC plans, and 7 that examined clinical outcomes. Chiropractic care was most commonly compared to care from a medical physician, with few details about the care received. Heterogeneity was noted among studies in patient selection, definition of spine pain, scope of costs compared, study duration, and methods to estimate costs. Overall, cost comparison studies from private health plans and WC plans reported that health care costs were lower with chiropractic care. In studies that also examined clinical outcomes, there were few differences in efficacy between groups, and health care costs were higher for those receiving chiropractic care. The effects of adjusting for differences in sociodemographic, clinical, or other factors between study groups were unclear.ConclusionsAlthough cost comparison studies suggest that health care costs were generally lower among patients whose spine pain was managed with chiropractic care, the studies reviewed had many methodological limitations. Better research is needed to determine if these differences in health care costs were attributable to the type of HCP managing their care.Electronic supplementary materialThe online version of this article (doi:10.1186/s12913-015-1140-5) contains supplementary material, which is available to authorized users.

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“…Twelve (48 %) studies examined data from private health plans in the US [ 22 – 33 ]. Six (24 %) studies examined data from worker’s compensation (WC) plans in the US [ 34 – 39 ].…”

Section: Resultsmentioning

confidence: 99%

“…lost productivity) account for a majority of the total costs of spine pain they are difficult to measure and often complex. Only 5/25 (20 %) measured these costs; they were generally lower for patients receiving chiropractic care [ 33 , 35 , 36 , 38 ].…”

Section: Discussionmentioning

confidence: 99%

A systematic review comparing the costs of chiropractic care to other interventions for spine pain in the United States

Dagenais

Brady

Haldeman

et al. 2015

BMC Health Serv Res

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“…Several studies have shown an association between chiropractic care and lower utilization of costly spine services such as all-class medications, diagnostic imaging, spinal injections, and surgery. [14][15][16] Two of these studies evaluated the cost of low back pain management when DCs were the first provider seen for an episode of care. In both studies when a DC was the portal of entry provider, the total cost was lower when compared to low back pain patients that had other entry points into the healthcare delivery (eg, physical therapy, medical specialty, etc) system.…”

Section: Discussionmentioning

confidence: 99%

“…In both studies when a DC was the portal of entry provider, the total cost was lower when compared to low back pain patients that had other entry points into the healthcare delivery (eg, physical therapy, medical specialty, etc) system. 15 Another study in a commercially insured population showed low back pain episodes initiated with DCs cost 20% less than those initiated with physicians. 17 Our findings and these other studies provide evidence suggesting that DCs can play an important role in the cost-effective management of low back pain populations and can be an integral resource to patients, providers, and policy makers.…”

Section: Discussionmentioning

confidence: 99%

Variations in Patterns of Utilization and Charges for the Care of Low Back Pain in North Carolina, 2000 to 2009: A Statewide Claims’ Data Analysis

Hurwitz

Guillen

et al. 2016

Journal of Manipulative and Physiological Therapeutics

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“…16,17 When chiropractic services are integrated into medical systems, the results may include improved patient outcomes, decreased use of other health care services, greater likelihood of adherence to clinical practice guidelines, satisfaction among stakeholders, and decreased health care costs. 7,18,19 Barriers to chiropractic integration into medical settings may exist. One barrier may be the lack of interprofessional education.…”

Section: Discussionmentioning

confidence: 99%

A Survey of American Chiropractic Association Members’ Experiences, Attitudes, and Perceptions of Practice in Integrated Health Care Settings

Bronston¹,

Austin-McClellan

Lisi

et al. 2015

Journal of Chiropractic Medicine

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Objective: The purpose of this study is to examine the self-report of experiences, attitudes, and perceived educational needs of American Chiropractic Association members regarding practice in integrated health care settings. Methods: This was a descriptive observational study of the American Chiropractic Association members. Participants completed an electronic survey reporting their current participation and interest in chiropractic integrated practice. Results: The survey was completed in 2011 by 1142 respondents, for a response rate of 11.8%. The majority of respondents (82.9%) did not currently practice in an integrated setting, whereas 17.1% did. Those practicing in various integrated medical settings reported delivering a range of diagnostic, therapeutic, and case management services. Participation in administrative and scholarly activities was less common. Respondents not practicing in integrated settings reported being interested in delivering a very similar array of clinical services. Doctors of chiropractic practicing in hospital or outpatient medical facilities reported frequent engagement in interprofessional collaboration. Both nonintegrated and integrated respondents reported very similar educational interests on a range of clinical topics.

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Tracking Low Back Problems in a Major Self-Insured Workforce

Abstract: Approaches marked by higher resource utilization and lower guideline congruence are linked to greater low back pain total costs. Total cost is a needed input for guideline development.

Cited by 23 publications

References 31 publications

A systematic review comparing the costs of chiropractic care to other interventions for spine pain in the United States

A systematic review comparing the costs of chiropractic care to other interventions for spine pain in the United States

Variations in Patterns of Utilization and Charges for the Care of Low Back Pain in North Carolina, 2000 to 2009: A Statewide Claims’ Data Analysis

A Survey of American Chiropractic Association Members’ Experiences, Attitudes, and Perceptions of Practice in Integrated Health Care Settings

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