 | The 131st Annual Meeting (November 15-19, 2003) of APHA |
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| The 131st Annual Meeting (November 15-19, 2003) of APHA |
Sandra M Magnetti, MS, DrPH1, Radoslaw Wasiak, PhD2, Eileen McNeely, PhD1, and Glenn Pransky, MD, MPH3. (1) School of Public Health-Dept of Enviromental and Occupational Medicine, Harvard University, 401 Park Drive, Landmark Center, Room 3-111, Boston, MA 02215, 617 384-6685, smagnett@hsph.harvard.edu, (2) Disability Research, Center for Disability Research, 71 Frankland Road, Hopkinton, MA 01748, (3) Liberty Mutual Center for Disability Research, 71 Frankland Road, Hopkinton, MA 01748
Among non-hospital providers, chiropractors provide about two-thirds more services per claim than physical/occupational therapists. They also receive the highest average payment per claim. Yet chiropractic services are among those health care interventions which utilization and efficacy is most heavily debated. According to the moral hazard literature generous workers’ compensation benefits are highly correlated with high utilization of services for back pain.
Objectives: To examine:
1. The relationship between chiropractic utilization of services and return to work
2. Whether high versus low use of chiropractic care relates to length of disability, recurrence of back injuries and the scope of medical treatment and overall costs
Methods
Identified occupational low back pain injuries with at least one visit to a chiropractor occurring between January 1, 1995 and December 31, 2001 in a large workers’ compensation insurer's database.
Examined the frequency of chiropractic care on a state-by state basis for existence of any shifts in chiropractic entitlement during the study period. States included: TX, PA, MA, FL, CT, IL, NY,CA
Results
Tracked the levels, variability, and shifts in utilization for chiropractic services, disability outcomes, and—what might be considered as a chiropractic care substitute—physical therapy revealed much variation.
Conclusions:
Our findings confirmed that there is a significant variation in average jurisdictional utilization of chiropractic care. We posit the likely reasons for changes in utilization within a particular jurisdiction during the study period for occupational low back pain. We discuss the implications of these variations for low back outcomes, including the cost of care.
Learning Objectives:
Keywords: Policy/Policy Development, Workers' Compensation
Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.