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The Costs and Outcomes of Chiropractic and Physician Care for Work-Related Back Pain

Marjorie Baldwin and William G. Johnson

Working Papers from East Carolina University, Department of Economics

Abstract: This article compares chiropractic and physician treatment of work-related back pain. The costs and outcomes associated with the two different approaches to care are estimated for a sample of approximately 850 California workers who completed an episode of work-related back pain in the years 1991 to 1993. Health care costs are obtained from data on payments to providers and indemnity costs are obtained from data on benefit payments to workers. The outcomes we consider are: the distribution of workers among claim types; the duration of work absences within claim types; and the prevalence of permanent impairments. The results show that chiropractors= patients have shorter average durations of work absence than physicians= patients but, among claims that do not involve permanent impairments, the savings in indemnity costs are more than offset by higher health care costs for chiropractic treatment. Among permanent disability claims, chiropractic treatment generates savings in indemnity and health care costs.

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