Stano M
School of Business Administration, Oakland University, Rochester, MI 48309-4401.
J Manipulative Physiol Ther. 1993 Jun;16(5):291-9.
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.
Retrospective statistical analysis of 2 yr of claims data on various categories of utilization and insurance payments for a large national sample of patients.
Ambulatory and inpatient care.
A total of 395,641 patients with one or more of 493 neuromusculoskeletal ICD-9 codes.
Hospital admission rates and 10 categories of insurance payments.
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.
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.
比较接受脊椎按摩治疗常见神经肌肉骨骼疾病的患者与仅由医学和整骨医生治疗的患者的医疗费用。
对大量全国患者样本的2年各类使用情况和保险赔付数据进行回顾性统计分析。
门诊和住院护理。
共有395641名患有493种神经肌肉骨骼ICD - 9编码中一种或多种疾病的患者。
住院率和10类保险赔付。
近四分之一的患者接受了脊椎按摩治疗师的治疗。在按服务收费部门，接受脊椎按摩治疗的患者第三方支付所代表的医疗费用显著较低。在患者总样本以及患有特定疾病的患者子样本中，发现两年期间总成本差异约为1000美元。成本较低主要归因于住院利用率较低。在控制患者人口统计学和保险计划特征后，成本差异仍具有统计学意义。
尽管正在努力控制病例组合可能存在的差异，并除了比较成本之外还比较治疗结果，但这些初步结果表明脊椎按摩治疗的使用者具有显著的成本节约潜力。结果还表明有必要重新审视相对于医疗覆盖范围限制脊椎按摩治疗覆盖范围的保险做法和计划。
