Study Shows Access to Chiropractic Care May Reduce Need for PCP Visits

Researchers performed a cross-sectional study of almost 18 million adults enrolled in Medicare from 2010 to 2011.  They were investigating whether access to chiropractic care could impact the use of PCP (Primary Care Practitioner) services.  With back and neck pain being 2 of the 5 most common diagnosis for disability, more people accessing health care through various private and government insurance programs,  and an aging population, there is concern about how this will affect the work load of PCPs, as well as the overall cost of health care.

Chiropractic became a covered service under Medicare in the 1970’s.  In recent years, the total spending on chiropractic care has increased significantly.  It almost doubled between 2006 and 2011.  In order to have an accurate understanding of that increase many factors must be considered, including how chiropractic care and medical care usage are related.  There is some evidence that more chiropractors are located in areas that also have a higher number of PCPs.  However, there is a lack of literature to show if chiropractic was being used in addition to or instead of PCP visits.  Therefore, the study objectives were:

  • to examine the relationship between the supply of chiropractic care and PCP services across the US;
  • to determine whether there is any association between the supply of chiropractic care and the number of visits to PCPs for back and/or neck pain
  • to estimate the impact of chiropractic care on national spending related to PCP visits.

US Medicare claims data from the Center for Medicaid & Medicare Services National Provider Identifier, Part B Carrier, MedPar, Inpatient, and Outpatient files was used for the study.  Of the nearly 18 million patients in the study, approximately 3 million made almost 6 million visits with a PCP for back or neck complaint.

After adjusting for other patient factors, it was apparent to the researchers that a higher supply of chiropractic care in an area was associated with fewer visits to PCPs for back and/or neck pain.  They found patients living in an area with high ratio of chiropractors were 15% less likely to seek a PCP visit for back pain and 10% less likely to seek a PCP visit for neck pain, when compared to those in living in areas with a low ratio of chiropractors per capita.

Based on this information, researchers “estimate that chiropractic care is associated with a reduction of 0.37 million visits to PCPs for back and/or neck pain at a total cost of $83.5 million”.  

Previous studies show private insurance beneficiaries with access to chiropractic care have lower health services costs than those without chiropractic benefits.  One study found that over only 5-10% of Medicare patients who received chiropractic care used other medical services concurrently indicating that chiropractic care may be used as a substitute for medical care for many patients with back and neck pain.  Previous research, together with this study, suggests that “chiropractic care among adults is associated with reduced spending on medicine and use of diagnostic tests in the population with private insurance. Among the Medicare population, chiropractic care may be beneficial in improving functional status among older adults.”

The data analysis also showed a significant variation in the number of both chiropractors (3.1 to 54.7 per 10,000 capita) and PCPs (18.9 to 237.1 per 10,000 capita) across the country.  When plotted on density maps, it is evident that while varied across the country, they distribution is overall “positively correlated.”

If you or a loved one is experiencing back and/or neck pain, talk to your local doctor of chiropractic.  Numerous studies and personal testimonies have shown chiropractic to be both safe and effective for many patients.  Studies such as this one, show it is also a cost-effective option.

SOURCE: “Regional Supply of Chiropractic Care and Visits to Primary Care Physicians for Back and Neck Pain” in Journal of the American Board of Family Medicine

doi: 10.3122/jabfm.2015.04.150005 J Am Board Fam Med July-August 2015 vol. 28 no. 4 481-490

*Article originally from the Tennessee Chiropractic Association