At the organization’s annual issues and research conference, a WCRI economist shared her research on chiropractic care among workers.
Although chiropractors are common care providers for back pain, there are not many studies on how common this type of treatment is in workers’ compensation and whether it improves outcomes. recovery or reduced claims costs.
This is a problem that WCRI decided to solve.
During the presentationModels and Outcomes of Chiropractic Care » At WCRI’s annual Issues & Research conference on Wednesday, March 16, one of the organization’s economists, Dongchun Wang, did some in-depth research into how chiropractic care is used in the workforce mix.
His work revolves around four main questions:
- How often do workers with low back pain receive chiropractic care in all states?
- What are the reasons for the substantial variation between states in the use of chiropractic care?
- How are chiropractors involved in the delivery of care?
- How do the costs and duration of temporary disability compare between low back pain claims with exclusive chiropractic care and those with non-chiropractic physical medicine care?
After the conference, WCRI CEO Dr. John Ruser hosted a question-and-answer session with the audience about Wang’s research.
Chiropractic Care Vs. Physical Therapy
Wang started his talk by giving a definition of chiropractic care.
“A chiropractor is a healthcare provider who diagnoses and treats patients with back pain,” Wang said. “You can basically think of it as a convenient treatment without prescription drugs or surgery.”
She then explained the differences between this mode of treatment and physical therapy, which also focuses on treating lower back injuries without medication or surgery.
“Physical therapists focus more on their physical exercises while chiropractors focus…on more hands-on treatment,” Wang said.
Some of the differences she described included the fact that chiropractors can make a diagnosis and create a care plan based on it, while physiotherapists create their treatment plan based on a diagnosis from a treating physician.
The study by the numbers
After establishing a definition of chiropractic care and detailing its differences from physiotherapy, Wang presented the results of his preliminary research to the audience.
She cautioned that the study’s findings cannot be generalized to all low back pain claims, as the WCRI only looked at those who received physical medicine care.
In this context, physical medicine is a branch of medicine, including physiotherapy, which focuses on the treatment of injury or disease by physical means such as manipulation, heat, electricity or radiation, rather than with medication or surgery.
Here’s a look at what she found:
- Of the 28 states in the study, 12 used chiropractic care in the comp Less than 5%.
- In the 16 states where chiropractic care was widespread, 29% of claims for lower back pain received physical medicine treatment from chiropractors.
- Minnesota, Wisconsin, California, New York and Delaware were the the first five states who used chiropractic care in comp.
- Half of the complaints where physical medicine was the only treatment had exclusive chiropractic care.
Cost Comparison: How Does Chiropractic Care Measure Up?
In terms of costs, Wang’s research found that costs were 47% lower in lower back pain claims treated exclusively with chiropractic care than those who received other physical medicine treatment.
Benefit payments were 35% lower for chiropractic claims and duration of temporary disability was 26% shorter.
Wang stressed that current data is limited, however, and WCRI will need to do more research to determine how chiropractic care affects claim outcomes.
“We need more data in this area to examine the results,” Wang said.
Interstate variations in chiropractic care
Although chiropractic care appears to be effective in treating injuries and may also reduce the costs and duration of claims, a number of states have used chiropractic care infrequently.
South Carolina, Arizona, Georgia, North Carolina, New Jersey, Florida, Indiana, Missouri, Virginia, Tennessee, Michigan, Nevada and Kansas have all used care chiropractic in less than 5% of lower back pain claims.
In contrast, Minnesota, the state where chiropractic care was most frequently used, turned to treatment nearly 30% of the time.
Wang offered two explanations for these interstate variations.
The first reason was related to supply and demand. She speculated that some states used chiropractic care more frequently because they simply had more chiropractors.
“Several studies outside of workers’ compensation have found a very strong correlation between the availability of chiropractors and the use of chiropractic care,” Wang said.
The second explanation had to do with state laws governing vendor selection. In states where workers’ compensation patients are allowed to choose their own providers, chiropractic care was used more frequently. All states — except Michigan — where chiropractic care is used less than 5% of the time have laws that allow insurers and employers to determine which providers self-employed patients can see.
“Utilization of chiropractic care is lower in these employer-controlled states compared to employee choices,” Wang said.
Although this research is still in its early stages, Wang expressed confidence that further studies will help shed light on when chiropractic care is appropriate in the workforce mix. &