Stano M
School of Business Administration, Oakland University, Rochester, MI 48039-4401.
J Manipulative Physiol Ther. 1994 Sep;17(7):442-6.
To compare the health care costs of patients who have received chiropractic treatment in insurance plans that do not restrict chiropractic or medical benefits with those treated solely by medical and osteopathic physicians.
Retrospective statistical analysis of 2 yr of claims data on total insurance payments and total outpatient payments.
Total insurance payments and total outpatient payments, each adjusted for sociodemographic characteristics.
Patients receiving chiropractic care experienced significantly lower total health care costs as represented by adjusted third-party payments in the fee-for-service sector. Total adjusted cost differences ranged from $291 to $1722 over the 2-yr period. Total adjusted outpatient costs tended to be slightly lower for medical patients but lower hospital utilization for chiropractic patients more than offsets the additional outpatient costs associated with chiropractic care.
The analysis of well-insured patients in plans that do not restrict the chiropractic benefit strengthens results previously reported. In this study, therefore, the favorable cost patterns for chiropractic patients cannot be attributed to insurance restrictions limiting reimbursement for chiropractic services relative to other services. Because adjustments for patient characteristics systematically reduce the cost advantages of chiropractic patients as compared to mean differences derived from unadjusted data, the results also demonstrate that adjusted values should be used for meaningful comparisons between the two groups of patients.
比较在不限制整脊治疗或医疗福利的保险计划中接受整脊治疗的患者与仅由医学和骨病医生治疗的患者的医疗保健费用。
对两年的保险索赔数据进行回顾性统计分析，内容包括保险总支付和门诊总支付。
保险总支付和门诊总支付，每项均根据社会人口统计学特征进行调整。
在按服务收费部门中，以调整后的第三方支付为代表，接受整脊治疗的患者的总医疗保健费用显著较低。在两年期间，调整后的总成本差异在291美元至1722美元之间。医学治疗患者的调整后门诊总费用往往略低，但整脊治疗患者较低的住院利用率足以抵消与整脊治疗相关的额外门诊费用。
对不限制整脊福利的保险计划中的参保良好患者进行的分析强化了先前报告的结果。因此，在本研究中，整脊治疗患者有利的费用模式不能归因于相对于其他服务而言限制整脊服务报销的保险限制。由于对患者特征进行调整会系统地降低整脊治疗患者与未调整数据得出的平均差异相比的成本优势，结果还表明应使用调整后的值对两组患者进行有意义的比较。
