Johnson M R, Schultz M K, Ferguson A C
Technique Department, Palmer College of Chiropractic, Davenport, IA 52803.
J Manipulative Physiol Ther. 1989 Oct;12(5):335-44.
The cost of care and the number of days lost because of work injury were analyzed from information gathered in a postal card survey sent to all Iowa back or neck injury claimants (sprain/strain) on record for 1984. Descriptive findings for the flow of care of the respondents were evaluated and a comparison made of the benefits and costs of care received by patients treated by chiropractic doctors (DCs), medical doctors (MDs) or osteopathic doctors (DOs). The analysis focused on those workers who lost enough time from work to qualify for compensation (4 days or more), whose cases were closed and who received all their care from one health professional. For those who received care from DCs (n = 266), the mean number of compensated days lost from work was at least 2.3 days less than for those who were treated by MDs (n = 494; p less than 0.025) and at least 3.8 days less than for those who were treated by DOs (n = 102; p less than 0.025). Consequently, much less money in employment compensation was paid, on the average, to those who saw DCs. Findings on provider care costs are less clear-cut because care-cost data on only a portion of the cases was recorded on the State records used. For the data available, the median provider cost was highest for patients who saw DCs, but the mean was highest for those who saw MDs. The study showed that 38% of claimants did change doctors. When change of provider occurred, days lost from work and cost of care varied widely across the care options, but generally, fewer workdays were lost and lower amounts of disability compensation and provider cost paid when chiropractic was included in the care pattern.
根据1984年寄给所有爱荷华州有背部或颈部损伤记录（扭伤/拉伤）的索赔人的明信片调查所收集的信息，分析了护理成本和因工伤损失的天数。对受访者的护理流程进行了描述性研究，并比较了接受脊椎按摩师（DC）、医生（MD）或整骨疗法医生（DO）治疗的患者所接受护理的收益和成本。分析集中在那些因工作损失足够时间以获得赔偿（4天或更多）、案件已结案且所有护理均由一名医疗专业人员提供的工人身上。对于接受DC治疗的人（n = 266），平均获得赔偿的误工天数比接受MD治疗的人（n = 494；p < 0.025）至少少2.3天，比接受DO治疗的人（n = 102；p < 0.025）至少少3.8天。因此，平均而言，看DC的人获得的就业赔偿要少得多。关于医疗服务提供者护理成本的研究结果不太明确，因为在所使用的州记录中，仅记录了部分病例的护理成本数据。就现有数据而言，看DC的患者的医疗服务提供者成本中位数最高，但平均数最高的是看MD的患者。研究表明，38%的索赔人确实更换了医生。当更换医疗服务提供者时，不同护理选择的误工天数和护理成本差异很大，但总体而言，当护理模式中包括脊椎按摩疗法时，误工天数较少，支付的残疾赔偿金和医疗服务提供者成本也较低。
