Table 8 Adjusted vs. unadjusted cost comparisons
Unadjusted health care costs | Comparator groups(s) | Adjusted health care costs | ||||||||
|---|---|---|---|---|---|---|---|---|---|---|
First author | Year | Risk adjustment variables | Chiropractic | Comparator | Lowest | Chiropractic | Comparator | Lowest | Comments | |
Butler [39] | 2010 | Physical function, back pain severity, leg pain severity | $868 | 1. MD care, 2 MD care + chiropractic care +/− PT care, 3. MD care + PT care, 4. Other | $264 | Comparator | $6,984 | $8,108 | Chiropractic | |
Carey [40] | 1995 | Physical function, sciatica, income, duration of pain, worker’s compensation | $684 | 1. Urban medical physician primary carea | $536 | Comparator | $699 | $523 | Comparator | |
2. Rural medical physician primary carea | ||||||||||
3. Orthopedista | ||||||||||
4. HMO provider (i.e. NPs and PAs) | ||||||||||
Haas [41] | 2005 | Health insurance, marital status, income | $222 | Medical physician care (i.e. prescription drugs, exercise, self-care advice, PT referral) | $211 | Comparator | N/A | N/A | Comparator | Adjusted costs were $14 higher for chiropractic care |
Kominski [45] | 2005 | Demographics, physical function, pain, copayments | $558 | 1. Medical physician care (i.e. back care advice, exercise, bed rest, narcotic analgesics, muscle relaxants, anti-inflammatories, OTC pain relievers) | $616 | Chiropractic | $570 | $567 | Comparator | |
2. Medical physician care + physical modalities (i.e. heat, cold, ultrasound, EMS, soft tissue and joint mobilization, mechanical traction, SET) | ||||||||||
Liliedahl [32] | 2010 | Symmetry Pharmacy Risk Groups (pharmacy claims, age, and sex) | $756 | MD care | $1,037 | Chiropractic | $533 | $661 | Chiropractic | |
Shekelle [31] | 1995 | Sociodemographics, health status, attitude, insurance status, location | $264 | 1. MD primary care, 2. orthopedist, 3. internist, 4. DO, 5. other providers | $166 | Comparator | N/A | N/A | Comparator | Adjusting changed estimates by $13 but did not change rank order of costs |
Stano [28] | 1996 | SysteMetrics classification | $518 | MD care | $1,020 | Chiropractic | N/A | N/A | Chiropractic | Risk adjusting did not change differences between groups |
Stano [23] | 1995 | SysteMetrics classification, age, sex, location, employee/dependent, insurance type, coinsurance, deductible, type of chiropractic coverage | $493 | MD care | $1,000 | Chiropractic | $508 | $542 | Chiropractic | |
Stano [24] | 1994 | Age, sex, region, work status, employee/dependent, health plan type | $5,474 | MD care | $8,427 | Chiropractic | N/A | N/A | Chiropractic | Adjusted costs were $1,197 lower for chiropractic care |
Stano [22] | 1993 | Age, sex, location, employee/dependent, work status, coinsurance, deductible, health plan coverage of chiropractic | $2,150 | MD care | $3,127 | Chiropractic | N/A | N/A | Chiropractic | Adjusted costs were 27 % lower for chiropractic care |