Chiropractic - Economics: Difference between revisions

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(New page: == Utilization and satisfaction rates == Chiropractic is the largest alternative medical profession in the U.S.<ref name=Kaptchuk-Eisenberg/> and is the 3rd largest doctored profession be...)
 
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Chiropractic is the largest alternative medical profession in the U.S.<ref name=Kaptchuk-Eisenberg/> and is the 3rd largest doctoralonl profession behind only [[medicine]] and [[dentistry]] in North America. <ref>{{cite web|url=http://gateway.nlm.nih.gov/MeetingAbstracts/ma?f=102184948.html|title=Establishing a database of U.S. chiropractic health manpower data: furthering the development of research infrastructure.|coauthors=Smith M, Morschhauser S. |publisher=National Library of Medicine|accessdate=2008-05-06}}</ref>
== Utilization and satisfaction rates ==
== Utilization and satisfaction rates ==
The percentage of population that utilize chiropractic care at any given time generally fall into a range from 6% to 12% in the U.S. and Canada,<ref name=Lawrence-Meeker/> with a global high of 20% in [[Alberta]].<ref name="Crownfield">{{cite journal |url=http://chiroweb.com/archives/25/06/02.html |title= Chiropractic in Alberta: a model of consumer utilization and satisfaction |journal= Dyn Chiropr |volume=25 |issue=6 |author= Crownfield PW |date=2007}}</ref> The vast majority who seek chiropractic care do so for relief from back and neck pain and other neuromusculoskeletal complaints;<ref>{{cite journal |journal= BMC Health Serv Res |date=2006 |volume=6 |issue=49 |title= A comparative analysis of chiropractic and general practitioner patients in North America: findings from the joint Canada/United States Survey of Health, 2002–03 |author= Hurwitz EL, Chiang LM |doi=10.1186/1472-6963-6-49 |pmid=16600038 |url=http://www.biomedcentral.com/1472-6963/6/49}}</ref> most do so specifically for low back pain.<ref name=Lawrence-Meeker/> [[Complementary and alternative medicine]] (CAM) practitioners such as chiropractors are often used as a complementary form of care to primary medical intervention.<ref name=Lawrence-Meeker>{{cite journal |journal= Chiropr Osteopat |date=2007 |volume=15 |issue=2 |title= Chiropractic and CAM utilization: a descriptive review |author= Lawrence DJ, Meeker WC |doi=10.1186/1746-1340-15-2 |pmid=17241465 |url=http://www.chiroandosteo.com/content/15/1/2}}</ref> Satisfaction rates are typically higher for chiropractic care compared to medical care, with quality of communication seeming to be a consistent predictor of patient satisfaction with chiropractors.<ref>{{cite journal |journal= J Manipulative Physiol Ther |date=2006 |volume=29 |issue=6 |pages=455–62 |title= Factors associated with patient satisfaction with chiropractic care: survey and review of the literature |author= Gaumer G |doi=10.1016/j.jmpt.2006.06.013 |pmid=16904491}}</ref> Despite high patient satisfaction scores, utilization of chiropractic care is sensitive to the costs incurred by the co-payment by the patient.<ref>{{cite book |author= Chapman-Smith DA, Cleveland CS III |chapter= International status, standards, and education of the chiropractic profession |pages=111–34 |title= Principles and Practice of Chiropractic |edition= 3rd ed. |editor= Haldeman S, Dagenais S, Budgell B ''et al.'' (eds.) |publisher=McGraw-Hill |date=2005 |isbn=0-07-137534-1}}</ref> The use of chiropractic is growing modestly; CAM as a whole is seeing wholesale increases.<ref name=Lawrence-Meeker/> Employment of U.S. chiropractors is expected to increase 14% between 2006 and 2016, faster than the average for all occupations.<ref name=BLS>{{cite web |url=http://stats.bls.gov/oco/ocos071.htm |author= Bureau of Labor Statistics |title= Occupational outlook handbook |date=2007 |accessdate=2008-02-14}}</ref> A 2008 survey stated that 69% of DC chiropractors disagree with the categorization of chiropractic as CAM, with 27% having some preference for the term "integrated medicine."<ref>{{cite journal |journal=J Altern Complement Med |date=2008 |volume=13 |issue=4 |pages=361-368 |title=Do Chiropractors Identify with Complementary and Alternative Medicine? Results of a Survey |doi=10.1089/acm.2007.0766 |pmid=18435599 |url=http://www.liebertonline.com/doi/abs/10.1089/acm.2007.0766}}</ref>
== Cost-effectiveness ==


Chiropractic is the largest alternative medical profession in the U.S.<ref name=Kaptchuk-Eisenberg/> and is the 3rd largest doctored profession behind [[medicine]] and [[dentistry]] in North America.<ref>{{cite web|url=http://gateway.nlm.nih.gov/MeetingAbstracts/ma?f=102184948.html|title=Establishing a database of U.S. chiropractic health manpower data: furthering the development of research infrastructure.|coauthors=Smith M, Morschhauser S. |publisher=National Library of Medicine|accessdate=2008-05-06}}</ref> The percentage of population that utilize chiropractic care at any given time generally fall into a range from 6% to 12% in the U.S. and Canada,<ref name=Lawrence-Meeker/> with a global high of 20% in [[Alberta]].<ref name="Crownfield">{{cite journal |url=http://chiroweb.com/archives/25/06/02.html |title= Chiropractic in Alberta: a model of consumer utilization and satisfaction |journal= Dyn Chiropr |volume=25 |issue=6 |author= Crownfield PW |date=2007}}</ref> The vast majority who seek chiropractic care do so for relief from back and neck pain and other neuromusculoskeletal complaints;<ref>{{cite journal |journal= BMC Health Serv Res |date=2006 |volume=6 |issue=49 |title= A comparative analysis of chiropractic and general practitioner patients in North America: findings from the joint Canada/United States Survey of Health, 2002–03 |author= Hurwitz EL, Chiang LM |doi=10.1186/1472-6963-6-49 |pmid=16600038 |url=http://www.biomedcentral.com/1472-6963/6/49}}</ref> most do so specifically for low back pain.<ref name=Lawrence-Meeker/> [[Complementary and alternative medicine]] (CAM) practitioners such as chiropractors are often used as a complementary form of care to primary medical intervention.<ref name=Lawrence-Meeker>{{cite journal |journal= Chiropr Osteopat |date=2007 |volume=15 |issue=2 |title= Chiropractic and CAM utilization: a descriptive review |author= Lawrence DJ, Meeker WC |doi=10.1186/1746-1340-15-2 |pmid=17241465 |url=http://www.chiroandosteo.com/content/15/1/2}}</ref> Satisfaction rates are typically higher for chiropractic care compared to medical care, with quality of communication seeming to be a consistent predictor of patient satisfaction with chiropractors.<ref>{{cite journal |journal= J Manipulative Physiol Ther |date=2006 |volume=29 |issue=6 |pages=455–62 |title= Factors associated with patient satisfaction with chiropractic care: survey and review of the literature |author= Gaumer G |doi=10.1016/j.jmpt.2006.06.013 |pmid=16904491}}</ref> Despite high patient satisfaction scores, utilization of chiropractic care is sensitive to the costs incurred by the co-payment by the patient.<ref>{{cite book |author= Chapman-Smith DA, Cleveland CS III |chapter= International status, standards, and education of the chiropractic profession |pages=111–34 |title= Principles and Practice of Chiropractic |edition= 3rd ed. |editor= Haldeman S, Dagenais S, Budgell B ''et al.'' (eds.) |publisher=McGraw-Hill |date=2005 |isbn=0-07-137534-1}}</ref> The use of chiropractic is growing modestly; CAM as a whole is seeing wholesale increases.<ref name=Lawrence-Meeker/> Employment of U.S. chiropractors is expected to increase 14% between 2006 and 2016, faster than the average for all occupations.<ref name=BLS>{{cite web |url=http://stats.bls.gov/oco/ocos071.htm |author= Bureau of Labor Statistics |title= Occupational outlook handbook |date=2007 |accessdate=2008-02-14}}</ref> A 2008 survey stated that 69% of DC chiropractors disagree with the categorization of chiropractic as CAM, with 27% having some preference for the term "integrated medicine."<ref>{{cite journal |journal=J Altern Complement Med |date=2008 |volume=13 |issue=4 |pages=361-368 |title=Do Chiropractors Identify with Complementary and Alternative Medicine? Results of a Survey |doi=10.1089/acm.2007.0766 |pmid=18435599 |url=http://www.liebertonline.com/doi/abs/10.1089/acm.2007.0766}}</ref>
A 2006 qualitative review found that the research literature suggests that chiropractic obtains at least comparable outcomes to alternatives with potential cost savings.<ref>{{cite journal |journal= J Manipulative Physiol Ther |date=2006 |volume=29 |issue=9 |pages=707–25 |title= Health services research related to chiropractic: review and recommendations for research prioritization by the chiropractic profession |author= Mootz RD, Hansen DT, Breen A, Killinger LZ, Nelson C |doi=10.1016/j.jmpt.2006.09.001 |pmid=17142165}}</ref> A 2006 UK systematic [[cost-effectiveness]] review found that the reported cost-effectiveness of chiropractic manipulation compares favorably with other treatments for back pain, but that reports are based on data from clinical trials without sham controls and that the specific cost-effectiveness of the treatment (as opposed to [[non-specific effect]]s) remains uncertain.<ref>{{cite journal |journal= Evid Based Complement Alternat Med |date=2006 |volume=3 |issue=4 |pages=425–32 |title= Cost-effectiveness of complementary therapies in the United kingdom—a systematic review |author= Canter PH, Coon JT, Ernst E |doi=10.1093/ecam/nel044 |pmid=17173105 |url=http://ecam.oxfordjournals.org/cgi/content/full/3/4/425}}</ref> A 2005 systematic review of economic evaluations of conservative treatments for low back pain found that significant quality problems in available studies meant that definite conclusions could not be drawn about the most cost-effective intervention.<ref>{{cite journal |journal= Best Pract Res Clin Rheumatol |date=2005 |volume=19 |issue=4 |pages=671–84 |title= What is the most cost-effective treatment for patients with low back pain? a systematic review |author= van der Roer N, Goossens MEJB, Evers SMAA, van Tulder MW |doi=10.1016/j.berh.2005.03.007 |pmid=15949783}}</ref> The cost-effectiveness of maintenance chiropractic care is unknown.<ref name=Leboeuf-Yde-C/>

Revision as of 04:03, 6 December 2010

Chiropractic is the largest alternative medical profession in the U.S.[1] and is the 3rd largest doctoralonl profession behind only medicine and dentistry in North America. [2]

Utilization and satisfaction rates

The percentage of population that utilize chiropractic care at any given time generally fall into a range from 6% to 12% in the U.S. and Canada,[3] with a global high of 20% in Alberta.[4] The vast majority who seek chiropractic care do so for relief from back and neck pain and other neuromusculoskeletal complaints;[5] most do so specifically for low back pain.[3] Complementary and alternative medicine (CAM) practitioners such as chiropractors are often used as a complementary form of care to primary medical intervention.[3] Satisfaction rates are typically higher for chiropractic care compared to medical care, with quality of communication seeming to be a consistent predictor of patient satisfaction with chiropractors.[6] Despite high patient satisfaction scores, utilization of chiropractic care is sensitive to the costs incurred by the co-payment by the patient.[7] The use of chiropractic is growing modestly; CAM as a whole is seeing wholesale increases.[3] Employment of U.S. chiropractors is expected to increase 14% between 2006 and 2016, faster than the average for all occupations.[8] A 2008 survey stated that 69% of DC chiropractors disagree with the categorization of chiropractic as CAM, with 27% having some preference for the term "integrated medicine."[9]

Cost-effectiveness

A 2006 qualitative review found that the research literature suggests that chiropractic obtains at least comparable outcomes to alternatives with potential cost savings.[10] A 2006 UK systematic cost-effectiveness review found that the reported cost-effectiveness of chiropractic manipulation compares favorably with other treatments for back pain, but that reports are based on data from clinical trials without sham controls and that the specific cost-effectiveness of the treatment (as opposed to non-specific effects) remains uncertain.[11] A 2005 systematic review of economic evaluations of conservative treatments for low back pain found that significant quality problems in available studies meant that definite conclusions could not be drawn about the most cost-effective intervention.[12] The cost-effectiveness of maintenance chiropractic care is unknown.[13]

  1. ↑
  2. ↑ "Establishing a database of U.S. chiropractic health manpower data: furthering the development of research infrastructure". National Library of Medicine. Retrieved 2008-05-06. Unknown parameter |coauthors= ignored (help)
  3. ↑ 3.0 3.1 3.2 3.3 Lawrence DJ, Meeker WC (2007). "Chiropractic and CAM utilization: a descriptive review". Chiropr Osteopat. 15 (2). doi:10.1186/1746-1340-15-2. PMID 17241465.
  4. ↑ Crownfield PW (2007). "Chiropractic in Alberta: a model of consumer utilization and satisfaction". Dyn Chiropr. 25 (6).
  5. ↑ Hurwitz EL, Chiang LM (2006). "A comparative analysis of chiropractic and general practitioner patients in North America: findings from the joint Canada/United States Survey of Health, 2002–03". BMC Health Serv Res. 6 (49). doi:10.1186/1472-6963-6-49. PMID 16600038.
  6. ↑ Gaumer G (2006). "Factors associated with patient satisfaction with chiropractic care: survey and review of the literature". J Manipulative Physiol Ther. 29 (6): 455–62. doi:10.1016/j.jmpt.2006.06.013. PMID 16904491.
  7. ↑ Chapman-Smith DA, Cleveland CS III (2005). "International status, standards, and education of the chiropractic profession". In Haldeman S, Dagenais S, Budgell B et al. (eds.). Principles and Practice of Chiropractic (3rd ed. ed.). McGraw-Hill. pp. 111–34. ISBN 0-07-137534-1.
  8. ↑ Bureau of Labor Statistics (2007). "Occupational outlook handbook". Retrieved 2008-02-14.
  9. ↑ "Do Chiropractors Identify with Complementary and Alternative Medicine? Results of a Survey". J Altern Complement Med. 13 (4): 361–368. 2008. doi:10.1089/acm.2007.0766. PMID 18435599.
  10. ↑ Mootz RD, Hansen DT, Breen A, Killinger LZ, Nelson C (2006). "Health services research related to chiropractic: review and recommendations for research prioritization by the chiropractic profession". J Manipulative Physiol Ther. 29 (9): 707–25. doi:10.1016/j.jmpt.2006.09.001. PMID 17142165.
  11. ↑ Canter PH, Coon JT, Ernst E (2006). "Cost-effectiveness of complementary therapies in the United kingdom—a systematic review". Evid Based Complement Alternat Med. 3 (4): 425–32. doi:10.1093/ecam/nel044. PMID 17173105.
  12. ↑ van der Roer N, Goossens MEJB, Evers SMAA, van Tulder MW (2005). "What is the most cost-effective treatment for patients with low back pain? a systematic review". Best Pract Res Clin Rheumatol. 19 (4): 671–84. doi:10.1016/j.berh.2005.03.007. PMID 15949783.
  13. ↑
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