Cost Effectiveness & Satisfaction — Base Camp Chiropractic

This study provides evidence that spinal mobilization is more effective and less costly for treating neck pain than physiotherapy or care by a general practitioner.

Findings from a study utilizing data from the North Carolina State Health Plan collected between 2000-2009 show that care by a doctor of chiropractic alone or chiropractic care in conjunction with care by a medical doctor incurred “appreciably fewer charges” for uncomplicated lower back pain, than MD care with or without care by a physical therapist. These findings were also demonstrated in patients with neck pain as well as headache.

This study examined older Medicare patients with chronic low back pain and other medical problems who received spinal manipulation from a chiropractic physician. Results found that chiropractic intervention resulted in lower costs of care and shorter episodes of back pain than patients in other treatment groups. Patients who received a combination of chiropractic and medical care had the next lowest Medicare costs, and patients who received medical care only incurred the highest costs.

Low back pain initiated with a doctor of chiropractic saves 40 percent on health care costs when compared with care initiated through a medical doctor, according to a study that analyzed data from 85,000 Blue Cross Blue Shield (BCBS) beneficiaries in Tennessee over a two-year span. The study population had open access to MDs and DCs through self-referral, and there were no limits applied to the number of MD/DC visits allowed and no differences in co-pays. Researchers estimated that allowing DC-initiated episodes of care would have led to an annual cost savings of $2.3 million for BCBS of Tennessee. They also concluded that insurance companies that restrict access to chiropractic care for low back pain treatment may inadvertently pay more for care than they would if they removed such restrictions.

This study shows chiropractic care to be relatively cost-effective for the treatment of chronic low-back pain. Chiropractic and medical care performed comparably for acute patients. Practice-based clinical outcomes were consistent with systematic reviews of spinal manipulative efficacy: manipulation-based therapy is at least as good as and, in some cases, better than other therapies.

This study documents a recent 629% increase in Medicare expenditures for epidural steroid injections; a 423% increase in expenditures for opioids for back pain; a 307% increase in the number of lumbar magnetic resonance images among Medicare beneficiaries; and a 220% increase in spinal fusion surgery rates. Prescribing more imaging, opioids, injections, and operations is not likely to improve outcomes for patients with chronic back pain.

This study provides evidence that patients of chiropractors were three times as likely as patients of family physicians to report that they were very satisfied with the care they received for low back pain (66% versus 22%, respectively). Compared with patients of family physicians, patients of chiropractors were much more likely to have been satisfied with the amount of information they were given, to have perceived that their provider was concerned about them, and to have felt that their provider was comfortable and confident dealing with their problem.

A study in the May issue of Consumer Reports shows hands-on therapies were tops among treatments for relief of back pain. The study, which surveyed more than 14,000 consumers, was conducted by the Consumer Reports Health Ratings Center. The report states that, "eighty-eight percent of those who tried chiropractic manipulation said it helped a lot, and 59 percent were 'completely' or 'very' satisfied with their chiropractor."

This article reports on satisfaction associated with the introduction of chiropractic services within a military hospital, through a Canadian Armed Forces Pilot Project. A 27-item survey was distributed that inquired about demographic information and satisfaction with chiropractic services to 102 military personnel presenting for on-site chiropractic services at the Archie McCallum Hospital in Halifax, Nova Scotia. The majority of military personnel (94.2%) and referring physicians (80.0%) expressed satisfaction with chiropractic services.

The results of this study generally confirm the findings elsewhere in the literature. Of the 23% of the adult population who have ever visited a chiropractor, overall rates of satisfaction are once again found to be quite high (83% satisfied or better) and the number dissatisfied is quite low (less than 10% dissatisfied or very dissatisfied). This is remarkable given the fact that much of the financial burden of the care is borne by patients, and the preponderance of care is for difficult chronic problems of the back and neck.

This study provides evidence that patients with acute neck pain were satisfied with chiropractic treatment and reported reductions in associated pain levels and activity restrictions. The overall patient satisfaction rate was 94%.

This study demonstrated a high satisfaction rate among managed-care patients when the following various aspects of chiropractic care were given a rating of "excellent" by respondents: Length of time to get an appointment (84.9%); convenience of the office (57.7%); access to the office by telephone (77.3%); length of wait at the office (75.7%); time spent with the provider (74.3%); explanation of what was done during the visit (72.8%); technical skills of the chiropractor (83.3%); and the personal manner of the chiropractor (92.4%). The visit overall was rated as excellent by 83.3% of responders, and 95.5% stated they would definitely recommend the provider to others.

In this randomized trial chiropractic patients were found to be more satisfied with their back care providers after four weeks of treatment than were medical patients. Additionally, studies conclude that patients are more satisfied with chiropractic care than they are with physical therapy after six weeks.

This Gallup poll shows that most Americans believe chiropractic is an effective way to treat back and neck pain. More than 33 million adults in the U.S. have seen a chiropractor in the last 12 months, and twice as many say a chiropractor would be their first choice to see for neck or back pain if they had it.

This overview discusses chiropractic care and recognizes it to be the largest, most regulated, and best recognized of the complementary and alternative medicine (CAM) professions. CAM patient surveys show that chiropractors are used more often than any other alternative provider group and patient satisfaction with chiropractic care is very high. There is steadily increasing patient use of chiropractic in the United States, which has tripled in the past two decades.