|
Chiropractic is now
firmly rooted in the public consciousness as a primary agent of
health care management. According to a 1990 study published in the
New England Journal of Medicine, the number of visits to
non-medical health care providers in 1990 totaled 425 million, 9.5%
more than the total number of visits to all family physicians. A
follow-up study determined that, in 1997, total visits to
non-medical providers amounted to 629 million, exceeding the total
projected visits to all primary care physicians by 63%. The New
England Journal of Medicine reported that Chiropractic was the
most used non-medical treatment.
Effectiveness of Chiropractic Care
Cost-Effectiveness of Chiropractic Care
Safety of Chiropractic Care
Patient Satisfaction With
Chiropractic Care
Studies on The
Effectiveness of Chiropractic Care
U.S. Government
Agency Report
In 1994, the Agency for Health Care Policy and Research
published Clinical Practice Guideline 14-Acute Low Back Problems
in Adults. According to the Guideline, spinal
manipulation is one of the most safe and effective treatments
for most cases of acute low-back pain.
The Rand Study
In this independent study by RAND (1992), an expert panel of
doctors of medicine and doctors of chiropractic reviewed 35 years of
research on spinal manipulation. They agreed that this is an
appropriate and effective treatment for many kinds of low back
pain. They concluded, "spinal manipulation hastens recovery from
acute uncomplicated low back pain".
The Manga
Report
A study conducted for the Ontario Ministry of Health (1993),
reported that spinal manipulation is the most effective treatment
for low-back pain and that spinal manipulation is "safer than
medical management of low-back pain".
British Medical
Journal
A study conducted by T.W. Meade, a medical doctor, and
reported in the British Medical Journal (1990) concluded,
after two years of patient monitoring, that "for patients with
low-back pain in whom manipulation is not contraindicated,
chiropractic almost certainly confers worthwhile, long-term benefit
in comparison with hospital outpatient management".
top
Studies on The
Cost-Effectiveness of Chiropractic Care
American
Journal of Managed Care (1996)
Concluded that for patients who had back or neck pain,
"chiropractic care was substantially more cost-effective than
conventional care".
Journal of
American Health Policy (1992)
A review of data from over 2,000,000 users of chiropractic
care in the U.S., stated that "chiropractic users tend to have
substantially lower total health care costs," and "chiropractic care
reduces the use of both physician and hospital care".
Medical Care
(1996)
Stano and Smith found that "for both total payments and
total outpatient payments, the mean cost of chiropractic first
episodes is substantially and significantly lower than medical
episodes with much of the difference in total costs because of
inpatient costs".
Chiropractic
Journal of Australia (1992)
In a study of work-related back pain claims in Australia,
Ebrall found that the percentage of cases managed by chiropractors
that required compensation days was half that of cases managed by
medical doctors. The likelihood of a claim progressing to 90-day,
or chronic status was three times more likely with medical
management than with chiropractic management.
top
Studies of the
Safety of Chiropractic Care
New Zealand
Commission (1979)
The New Zealand Government commissioned and extensive
20-month study on Chiropractic care. Chiropractors, medical doctors
and researchers from all over the world contributed to the project.
The 3,000 page report concluded: "We are satisfied that
chiropractic treatment...is remarkably safe. Tens of
thousands of patients have gone through chiropractors' hands...(and)
they have apparently suffered no ill effects...We have no doubt that
chiropractors' training adequately equips them to carry out their
techniques without harm to the patient."
The Agency on Health
Care Policy and Research Study
On December 8, 1994, the Agency for Health Care Policy and
Research (AHCPR) of the US Department of Health and Human
Services released Clinical Practice Guidelines for the management of
acute low back pain. Their guidelines were developed after extensive
study of diagnostic and treatment methods for acute low back pain.
The guidelines were created by the AHCPR panel to provide primary
care clinicians with information and recommended strategies for the
assessment and treatment of acute low back problems. The AHCPR panel
was made up of 23 members consisting of medical doctors,
chiropractic doctors, nurses, experts in spinal research, physical
therapists, an occupational therapist, a psychologist, and a
consumer representative.
Their
findings included:
- The
risk of serious complications from lumbar spinal
manipulation is rare;
- Conservative
treatment such as spinal manipulation should be pursued in
most cases before considering surgical intervention;
- Prescription
drugs such as oral steroids, antidepressant medications and
colchicine are not recommended for acute low back
problems.
Acute
Low Back Problems in Adults. Clinical Practice Guidelines. Bigos
S, et al. Agency for Health Care Policy and Research Publication
No. 950642 (1994) - U.S. Department of Health and Human Services.
The Manga
Report
The
Ontario Ministry of Health commissioned Manga Report represents the
largest analysis of scientific literature on the most effective and
cost effective treatments for low back pain. After reviewing all of
the international evidence on the management of low back pain, lead
investigator Pran Manga, Ph.D., found the treatments provided by
Doctors of Chiropractic were exceptionally safe - much safer than
for standard medical treatments of similar conditions.
- "There is
no clinical or case-control study that demonstrates or even
implies that chiropractic spinal manipulation is unsafe in
the treatment of low back pain. Some medical treatments are
equally safe, but others are unsafe and generate iatrogenic
(doctor-induced) complications for low back pain patients. Our
reading of the literature suggests that chiropractic
manipulation is safer than medical management of low back pain."
- "Indeed,
several existing medical therapies of low back pain are
generally contraindicated on the basis of the existing clinical
trials. There is also some evidence in the literature to suggest
that spinal manipulations are less safe and less effective
when performed by nonchiropractic professionals"
- "Chiropractic
manipulation is safer than medical management of low back pain.
Chiropractic management is greatly superior to medical
management in terms of scientific validity, safety,
cost-effectiveness and patient satisfaction."
The
Effectiveness and Cost Effectiveness of Chiropractic Management of
Low-Back Pain (The Manga Report). Pran Manga and Associates (1993) -
University of Ottawa, Canada.
top
Studies
on Patient Satisfaction with Chiropractic Care
The Gallop Study
(1991)
In 1991 the Gallup Organization performed a nationwide demographic study
to determine the attitudes, opinions, and behaviors of both users and
nonusers of chiropractic services.
Their findings?
Overall, 90% felt that chiropractic health care was effective: more than
80% were satisfied with the treatment they received; nearly 75% felt
that most of their expectations were met during the last visit or series
of visits; 68% said they would likely see a doctor of chiropractic again
for treatment of a similar condition, and 50% would likely be willing to
see a doctor of chiropractic for some other problem chiropractors treat.
Nearly 80% of the chiropractic users felt that the cost of chiropractic
treatment was reasonable.
Demographic
Characteristics of Users of Chiropractic Services. The Gallup Organization,
Princeton, New Jersey - 1991.
The Magna Report
As the largest existing analysis
of scientific literature on low back pain, the 1993 Ontario Ministry of
Health commissioned study drew international attention when it recommended the
management of low back pain be moved from medical doctors to chiropractic
doctors.
Due to serious financial problems with the Canadian governments, the different
types of treatments for low back conditions were evaluated in an effort to
reduce and contain health care costs. Their findings showed chiropractic
manipulation was the most cost effective and efficacious care for low back pain.
According to lead investigator Pran Manga, Ph.D., "There is good
empirical evidence that patients are very satisfied with chiropractic management
of low back pain and considerably less satisfied with medical physician
management."
The
Effectiveness and Cost Effectiveness of Chiropractic Management of Low-Back
Pain. Pran Manga and Associates. University of Ottawa, Canada - 1993.
The Harris Poll
According to this 1994 Harris Poll, patients were more satisfied with
chiropractic care than care from medical doctors and other health care
professionals.
Those who sought care from a chiropractor were more likely to be very satisfied
with their care than those who visited any other practitioner. (Choices were
between Chiropractic Doctors, Medical Doctors, Physical Therapists, or
Osteopathic Doctors) Of those who have seen both types of practitioner, the
majority were more likely to be satisfied with the care of the chiropractor than
with that of the medical doctor.
1994
Harris Poll.
Patient Evaluations of Care
from Family Physicians and Chiropractors
Findings from this study indicate that patients under chiropractic care had 3
times the satisfaction rate as did patients under the care of Family
Physicians. In addition, the patient's perception of the doctor's confidence
in diagnosing and treating low back pain was almost 3 times higher in patients
receiving chiropractic care compared with those receiving care from family
physicians.
Patient
Evaluations of Care from Family Physicians and Chiropractors. Cherkin, D.,
MacCornack, F. Western Journal of Medicine - 1989;150:351-355.
top
|
