Chiropractic and medical costs of low back care.


:This study compares health insurance payments and patient utilization patterns for episodes of care for common lumbar and low back conditions treated by chiropractic and medical providers. Using 2 years of insurance claims data, this study examines 6,183 patients who had episodes with medical or chiropractic first-contact providers. Multiple regression analysis, to control for differences in patient, clinical, and insurance characteristics, indicates that total insurance payments were substantially greater for episodes with a medical first-contact provider. Most of the cost differences were because of higher inpatient payments for such cases. Analysis of recurrent episodes indicates that chiropractic providers retain more patients for subsequent episodes and that patient exposure to a different provider type during early episodes significantly affects retention rates for later episodes. Patients choosing chiropractic and medical care were comparable on measures of severity and in lapse time between episodes. The lower costs for episodes in which chiropractors serve as initial contact providers along with the favorable satisfaction and quality indicators for patients suggest that chiropractic deserves careful consideration in gatekeeper strategies adopted by employers and third-party payers to control health care spending. More research is needed, especially in developing alternative measures of health status and outcomes.


Med Care


Medical care


Stano M,Smith M




Has Abstract


1996-03-01 00:00:00












  • The measurement of expenditures for outpatient physician and dental services: methodological findings from the health insurance study.

    abstract::Survey data measuring outpatient health expenditure are evaluated for item nonresponse, measurement error, and bias. Item nonresponse is high for persons whose health care is financed through the public sector, but is otherwise manageable. Estimates of mean total and out-of-pocket physician and dental expenditure from...

    journal_title:Medical care

    pub_type: 杂志文章


    authors: Marquis KH,Marquis MS,Newhouse JP

    更新日期:1976-11-01 00:00:00

  • Predictors of patients' perceived need for medication to prevent fracture.

    abstract:BACKGROUND:Adherence with medications to prevent fractures is suboptimal. Patients' perceived need for medication is an important predictor of medication-use behavior. OBJECTIVE:Estimate the associations of patients' perceived need of medication for fracture prevention with objective indicators of fracture risk, patie...

    journal_title:Medical care

    pub_type: 杂志文章


    authors: Schousboe JT,Davison ML,Dowd B,Thiede Call K,Johnson P,Kane RL

    更新日期:2011-03-01 00:00:00

  • Impact of Medicare's Nonpayment Program on Hospital-acquired Conditions.

    abstract:BACKGROUND:Medicare's Nonpayment Program of 2008 (hereafter called Program) withholds hospital reimbursement for costs related to hospital-acquired conditions (HACs). Little is known whether a hospital's Medicare patient load [quantified by the hospital's Medicare utilization ratio (MUR), which is the proportion of inp...

    journal_title:Medical care

    pub_type: 杂志文章


    authors: Thirukumaran CP,Glance LG,Temkin-Greener H,Rosenthal MB,Li Y

    更新日期:2017-05-01 00:00:00

  • Tonsillectomies, adenoidectomies, audits: have surgical indications been met?

    abstract::In the Seattle Prepaid Health Care Project, we studied medical records and claims information for all 97 children undergoing tonsillectomy and/or adenoidectomy in an independent practice plan from February 1971, through January 1975. Overall only 32 per cent of the procedures met commonly promulgated indications of su...

    journal_title:Medical care

    pub_type: 杂志文章


    authors: LoGerfo JP,Dynes IM,Frost F,Diehr PK,Richardson WC

    更新日期:1978-11-01 00:00:00

  • HIV testing of asymptomatic patients in U.S. hospitals.

    abstract::The human immunodeficiency virus (HIV) epidemic and the prevalence of HIV-positive persons in the population has provoked marked anxiety among hospital staffs of acquiring nosocomially transmitted HIV infections. A national telephone survey of key staff in a sample of 561 acute-care hospitals was undertaken to describ...

    journal_title:Medical care

    pub_type: 杂志文章


    authors: Freeman HE

    更新日期:1991-02-01 00:00:00

  • Health Care Experiences of Latino Children in Emerging and Traditional Destinations.

    abstract:BACKGROUND:Latino populations have disproportionately moved to areas in the Southeast and Midwest (emerging destinations), outside traditional Latino enclaves, in recent years. OBJECTIVE:To examine whether health care experiences differ between traditional and emerging destinations for Latino children. RESEARCH DESIG...

    journal_title:Medical care

    pub_type: 杂志文章


    authors: Saloner B,Gresenz CR

    更新日期:2016-05-01 00:00:00

  • Toward a new payment system for inpatient rehabilitation. Part II: Reimbursing providers.

    abstract:BACKGROUND:The major fault with existing reimbursement systems lies in their failure to discriminate for the effectiveness of stay, both when paying per day and when paying per episode of treatment. OBJECTIVES:We sought to define an average length of effective stay and recovery trends by impairment category, to design...

    journal_title:Medical care

    pub_type: 杂志文章,多中心研究


    authors: Saitto C,Marino C,Fusco D,Arcà M,Perucci CA,Prospective Payment in Rehabilitation Collaborative Group.

    更新日期:2005-09-01 00:00:00

  • A comparison of the patients and practices of recent graduates of family practice and general internal medicine residency programs.

    abstract::This study compares the characteristics of the practices and patients of recent graduates of family practice and general internal medicine residency programs. National samples of 104 family physicians and 134 general internists completed questionnaires and provided log-diary data for more than 7,500 office visits and ...

    journal_title:Medical care

    pub_type: 杂志文章


    authors: Cherkin DC,Rosenblatt RA,Hart LG,Schleiter MK

    更新日期:1986-12-01 00:00:00

  • A re-appraisal of the productivity potential and economic benefits of physician's assistants.

    abstract::A combined optimization-simulation model is used to examine the extent of productivity and economic benefits to be gained from adding a physician's assistant to a one-physician ambulatory health care practice. It is shown that previous models (which have predicted productivity gains as large as 90 per cent) have overs...

    journal_title:Medical care

    pub_type: 杂志文章


    authors: Hershey JC,Kropp DH

    更新日期:1979-06-01 00:00:00

  • The rural health care workforce implications of practice guideline implementation.

    abstract:BACKGROUND:Rural health care workforce forecasting has not included adjustments for predictable changes in practice patterns, such as the introduction of practice guidelines. PURPOSE:To estimate the impact of a practice guideline for a single health condition on the needs of a rural health professional workforce. MET...

    journal_title:Medical care

    pub_type: 杂志文章


    authors: Yawn BP,Casey M,Hebert P

    更新日期:1999-03-01 00:00:00

  • Hospital efficiency measurement and evaluation. Empirical test of a new technique.

    abstract::A new technique for identifying inefficient hospitals, Data Envelopment Analysis (DEA), is field tested by application to a group of teaching hospitals. DEA is found to provide meaningful insights into the location and nature of hospital inefficiencies as judged by the opinion of a panel of hospital experts. DEA provi...

    journal_title:Medical care

    pub_type: 杂志文章


    authors: Sherman HD

    更新日期:1984-10-01 00:00:00

  • Development of an instrument to measure job satisfaction among dentists.

    abstract::Because of the rapid changes that have occurred in the dental profession, the Dentist Satisfaction Survey (DSS) was developed to assess both facet and overall job satisfaction among dentists. The DSS was administered to a sample of 558 California general dentists. The results suggest that the DSS is a practical, relia...

    journal_title:Medical care

    pub_type: 杂志文章


    authors: Shugars DA,Hays RD,DiMatteo MR,Cretin S

    更新日期:1991-08-01 00:00:00

  • Information needs for medication coverage decisions in a state Medicaid program.

    abstract:BACKGROUND:Health plans commonly face the conflicting demands of trying to provide access to novel technologies, including new classes of medications, while trying to contain costs. These demands are particularly acute for California's Medicaid program, known as Medi-Cal, which is responsible for delivery of medical ca...

    journal_title:Medical care

    pub_type: 杂志文章


    authors: Croghan TW,Johnstone BM,Buesching DP,Kessler RC

    更新日期:1999-04-01 00:00:00

  • Insurance continuity and receipt of diabetes preventive care in a network of federally qualified health centers.

    abstract:BACKGROUND AND OBJECTIVES:Having health insurance is usually associated with better access to care and better health outcomes. For patients receiving care at Federally Qualified Health Centers (FQHCs), where care is provided regardless of insurance status, the role health insurance status plays in affecting receipt of ...

    journal_title:Medical care

    pub_type: 杂志文章


    authors: Gold R,DeVoe J,Shah A,Chauvie S

    更新日期:2009-04-01 00:00:00

  • Influence of Peer Physicians on Intensity of End-of-Life Care for Cancer Decedents.

    abstract:BACKGROUND:The intensity of end-of-life care varies substantially both within and between areas. Differing practice patterns of individual physicians are likely influenced by their peers. OBJECTIVE:To assess whether intensity of end-of-life care previously provided by a physician's peers influences patterns of care at...

    journal_title:Medical care

    pub_type: 杂志文章


    authors: Keating NL,O'Malley AJ,Onnela JP,Gray SW,Landon BE

    更新日期:2019-06-01 00:00:00

  • The disparity in access to new medication by type of health insurance: lessons from Germany.

    abstract:BACKGROUND:Drug provision within the German statutory health insurance system has undergone several reforms, including the introduction of drug macrobudgets in 1993. OBJECTIVE:The objective of this study was to investigate the extent to which statutorily (SHI) and fully privately (PHI) health-insured patients were pro...

    journal_title:Medical care

    pub_type: 杂志文章


    authors: Krobot KJ,Miller WC,Kaufman JS,Christensen DB,Preisser JS,Ibrahim MA

    更新日期:2004-05-01 00:00:00

  • Performance of the Medicare Consumer Assessment of Health Care Providers and Systems (CAHPS) Physical Functioning Items.

    abstract:BACKGROUND:Physical functioning is an important health domain for adults. OBJECTIVE:Evaluate physical functioning items in Medicare beneficiaries. RESEARCH DESIGN:Survey data from the 2010 Consumer Assessment of Healthcare Providers and Systems Medicare survey. SUBJECTS:The 366,701 respondents were 58% female; 38% w...

    journal_title:Medical care

    pub_type: 杂志文章


    authors: Hays RD,Mallett JS,Gaillot S,Elliott MN

    更新日期:2016-02-01 00:00:00

  • Electronic health record-based cardiac risk assessment and identification of unmet preventive needs.

    abstract:BACKGROUND:Cardiac risk assessment may not be routinely performed. Electronic health records (EHRs) offer the potential to automate risk estimation. We compared EHR-based assessment with manual chart review to determine the accuracy of automated cardiac risk estimation and determination of candidates for antiplatelet o...

    journal_title:Medical care

    pub_type: 杂志文章


    authors: Persell SD,Dunne AP,Lloyd-Jones DM,Baker DW

    更新日期:2009-04-01 00:00:00

  • Dental care in the People's Republic of China.

    abstract::In comparison to the living conditions that existed before 1949, the People's Republic of China (PRC) represents a remarkable story of achievement. Western knowledge about the PRC has recently increased by leaps and bounds as detente with the United States has allowed many Americans to witness the "awakening of the dr...

    journal_title:Medical care

    pub_type: 杂志文章


    authors: Louie R

    更新日期:1978-07-01 00:00:00

  • The two dimensions in satisfaction with dental care.

    abstract::Satisfaction with health services is an aspect of quality of care that is of special importance for captive clients like low-income clinic users. Several methodologies have been reported, but validation has been difficult. This study compares two older scaling techniques with a new, nonmetric method to detect underlyi...

    journal_title:Medical care

    pub_type: 杂志文章


    authors: Hengst A,Roghmann K

    更新日期:1978-03-01 00:00:00

  • Evaluating long-term care demonstrations in real time with study design and plan performance interactions.

    abstract::The evaluation of long-term care demonstrations has to deal with complex organizational entities, with large, heterogeneous client populations that, during the course of study, may have to change features of their organization or operation. The implications of such "real-time" changes are discussed for analyses of the...

    journal_title:Medical care

    pub_type: 杂志文章


    authors: Manton KG,Newcomer R,Lowrimore GR,Vertrees JC,Harrington C

    更新日期:1995-12-01 00:00:00

  • Predictors of safety belt initiative by primary care physicians. A social learning theory perspective.

    abstract::Even with the passage of state safety belt laws, primary care physicians can contribute to their patients' safety by brief interventions. The present study explores the prevalence of such action with adult patients and tests the power of constructs taken from social learning theory to explain physicians' behavior. The...

    journal_title:Medical care

    pub_type: 杂志文章


    authors: Mullen PD,Gottlieb NH,Biddle AK,McCuan RA,McAlister AL

    更新日期:1988-04-01 00:00:00

  • Differences in Consumer Assessment of Healthcare Providers and Systems Clinician and Group Survey Scores by Recency of the Last Visit: Implications for Comparability of Periodic and Continuous Sampling.

    abstract:BACKGROUND:Patient experience data can be collected by sampling patients periodically (eg, patients with any visits over a 1-year period) or sampling visits continuously (eg, sampling any visit in a monthly interval). Continuous sampling likely yields a sample with more frequent and more recent visits, possibly affecti...

    journal_title:Medical care

    pub_type: 社论


    authors: Setodji CM,Burkhart Q,Hays RD,Quigley DD,Skootsky SA,Elliott MN

    更新日期:2019-12-01 00:00:00

  • Mental health and selection of preferred providers. Experience in three employee groups.

    abstract::While Preferred Provider Organizations (PPOs) are designed to contain the costs of health care, they may not be able to do so if sicker individuals opt not to use PPO providers. This study examined how level of mental health status and prior use of mental health services affected the decision to use or not use PPO pro...

    journal_title:Medical care

    pub_type: 杂志文章


    authors: Wells KB,Marquis MS,Hosek SD

    更新日期:1991-09-01 00:00:00

  • Health care utilization and costs in a Medicare population by fall status.

    abstract:OBJECTIVES:The economic impact of trauma in older persons is a matter of increasing concern to public health practitioners and planners, yet it is an issue that has not been widely studied. Available evidence does suggest, however, that falls are the costliest category of injury among older persons. METHODS:This study...

    journal_title:Medical care

    pub_type: 杂志文章


    authors: Rizzo JA,Friedkin R,Williams CS,Nabors J,Acampora D,Tinetti ME

    更新日期:1998-08-01 00:00:00

  • Quality of acute episodic care in investor-owned ambulatory health centers.

    abstract::This article examines the quality of acute episodic care for five diagnostic categories amenable to one-visit diagnosis and treatment at the nation's largest chain of investor-owned ambulatory care centers. A total of 803 medical records were audited for five common conditions and measured against specific protocols. ...

    journal_title:Medical care

    pub_type: 杂志文章


    authors: Parks CL,Cashman S,Winickoff RN,Bicknell WJ

    更新日期:1991-01-01 00:00:00

  • Predicting outcome in the intensive care unit using scoring systems: is new better? A comparison of SAPS and SAPS II in a cohort of 1,393 patients. GiViTi Investigators (Gruppo Italiano per la Valutazione degli interventi in Terapia Intensiva). Simplified

    abstract:OBJECTIVES:This study sought to compare the performance of the old and new versions of the Simplified Acute Physiology Score, SAPS and SAPS II, in classifying patients according to the risk of hospital mortality. METHODS:To compare the performance of the two systems, measures of association between the scores and obse...

    journal_title:Medical care

    pub_type: 杂志文章,多中心研究


    authors: Bertolini G,D'Amico R,Apolone G,Cattaneo A,Ravizza A,Iapichino G,Brazzi L,Melotti RM

    更新日期:1998-09-01 00:00:00

  • A comparison of four indirect methods of assessing utility values in rheumatoid arthritis.

    abstract:OBJECTIVES:Utility scores can be assessed indirectly using preference-based instruments and used as weightings for quality-adjusted life years in economic analyses. It is not clear whether available instruments yield similar results or what domains of health are contributing to the overall score in a sample of patients...

    journal_title:Medical care

    pub_type: 杂志文章


    authors: Marra CA,Esdaile JM,Guh D,Kopec JA,Brazier JE,Koehler BE,Chalmers A,Anis AH

    更新日期:2004-11-01 00:00:00

  • Posttraumatic concerns: a patient-centered approach to outcome assessment after traumatic physical injury.

    abstract:BACKGROUND:Approximately 2.5 million Americans are admitted to the hospital after traumatic physical injury each year. Few investigations have elicited patients' perspectives regarding posttraumatic outcomes. OBJECTIVE:To identify and categorize physically injured trauma survivors' posttraumatic concerns. RESEARCH DE...

    journal_title:Medical care

    pub_type: 杂志文章


    authors: Zatzick DF,Kang SM,Hinton WL,Kelly RH,Hilty DM,Franz CE,Le L,Kravitz RL

    更新日期:2001-04-01 00:00:00

  • Long-term impact of Medicare managed care on patients treated for coronary artery disease.

    abstract:BACKGROUND:Planned health insurance reform promises and has started to cut reimbursement to Medicare managed care (MMC) plans. If such plans provide better care, adjusting for possible better health of their enrollees, then such reimbursement changes may have unforeseen quality consequences. OBJECTIVES:To examine whet...

    journal_title:Medical care

    pub_type: 杂志文章


    authors: Huesch MD

    更新日期:2012-01-01 00:00:00