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Clinical, demographic, and geographic determinants of variation in chiropractic episodes of care for adults using the 2005-2008 Medical Expenditure Panel Survey.
J Manipulative Physiol Ther. 2012 Oct; 35(8):589-99.JM

Abstract

OBJECTIVE

The primary aim of this study was to report nationally representative estimates of the visit utilization, per visit expenditures, and total expenditures for chiropractic episodes of care in the US adult population. The secondary aim was to identify clinical, demographic, geographic, and payment factors associated with variation in the levels of utilization and expenditures.

METHODS

Data from the 2005-2008 Medical Expenditure Panel Survey were used to construct complete episodes of chiropractic care (n = 1639) for the civilian, noninstitutionalized adult population. Bivariate descriptive statistics were calculated for visit utilization, per visit expenditures, and total expenditures per episode of care by several clinical, demographic, geographic, and payment variables. Multivariable regression models were used to evaluate the effects of the independent variables on each of the 3 dependent variables.

RESULTS

The unadjusted mean number of visits per episode was 5.8 (95% confidence interval [CI], 5.3-6.4] and varied significantly by race/ethnicity, perceived mental health, urban-rural location, and source of payment. The mean total expenditures per visit per episode were estimated to be $69 (95% CI, $65-$73). There was variation associated with the census region, urban-rural location, and source of payment variables. Total expenditures for an episode of care were estimated to be $424 (95% CI, $371-$477] with variation according to urban-rural location and source of payment. During 29% of the episodes all expenditures were paid with out-of-pocket funds.

CONCLUSIONS

Variation in the utilization and expenditures during chiropractic episodes of care is primarily associated with payment source and geographic factors.

Authors+Show Affiliations

Department of Physical Therapy, University of Pittsburgh, Pittsburgh, PA, USA. Jms363@pitt.eduNo affiliation info available

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural

Language

eng

PubMed ID

23158464

Citation

Stevans, Joel M., and Marc W. Zodet. "Clinical, Demographic, and Geographic Determinants of Variation in Chiropractic Episodes of Care for Adults Using the 2005-2008 Medical Expenditure Panel Survey." Journal of Manipulative and Physiological Therapeutics, vol. 35, no. 8, 2012, pp. 589-99.
Stevans JM, Zodet MW. Clinical, demographic, and geographic determinants of variation in chiropractic episodes of care for adults using the 2005-2008 Medical Expenditure Panel Survey. J Manipulative Physiol Ther. 2012;35(8):589-99.
Stevans, J. M., & Zodet, M. W. (2012). Clinical, demographic, and geographic determinants of variation in chiropractic episodes of care for adults using the 2005-2008 Medical Expenditure Panel Survey. Journal of Manipulative and Physiological Therapeutics, 35(8), 589-99. https://doi.org/10.1016/j.jmpt.2012.09.009
Stevans JM, Zodet MW. Clinical, Demographic, and Geographic Determinants of Variation in Chiropractic Episodes of Care for Adults Using the 2005-2008 Medical Expenditure Panel Survey. J Manipulative Physiol Ther. 2012;35(8):589-99. PubMed PMID: 23158464.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Clinical, demographic, and geographic determinants of variation in chiropractic episodes of care for adults using the 2005-2008 Medical Expenditure Panel Survey. AU - Stevans,Joel M, AU - Zodet,Marc W, PY - 2012/08/02/received PY - 2012/09/03/revised PY - 2012/09/17/accepted PY - 2012/11/20/entrez PY - 2012/11/20/pubmed PY - 2013/4/30/medline SP - 589 EP - 99 JF - Journal of manipulative and physiological therapeutics JO - J Manipulative Physiol Ther VL - 35 IS - 8 N2 - OBJECTIVE: The primary aim of this study was to report nationally representative estimates of the visit utilization, per visit expenditures, and total expenditures for chiropractic episodes of care in the US adult population. The secondary aim was to identify clinical, demographic, geographic, and payment factors associated with variation in the levels of utilization and expenditures. METHODS: Data from the 2005-2008 Medical Expenditure Panel Survey were used to construct complete episodes of chiropractic care (n = 1639) for the civilian, noninstitutionalized adult population. Bivariate descriptive statistics were calculated for visit utilization, per visit expenditures, and total expenditures per episode of care by several clinical, demographic, geographic, and payment variables. Multivariable regression models were used to evaluate the effects of the independent variables on each of the 3 dependent variables. RESULTS: The unadjusted mean number of visits per episode was 5.8 (95% confidence interval [CI], 5.3-6.4] and varied significantly by race/ethnicity, perceived mental health, urban-rural location, and source of payment. The mean total expenditures per visit per episode were estimated to be $69 (95% CI, $65-$73). There was variation associated with the census region, urban-rural location, and source of payment variables. Total expenditures for an episode of care were estimated to be $424 (95% CI, $371-$477] with variation according to urban-rural location and source of payment. During 29% of the episodes all expenditures were paid with out-of-pocket funds. CONCLUSIONS: Variation in the utilization and expenditures during chiropractic episodes of care is primarily associated with payment source and geographic factors. SN - 1532-6586 UR - https://www.unboundmedicine.com/medline/citation/23158464/Clinical_demographic_and_geographic_determinants_of_variation_in_chiropractic_episodes_of_care_for_adults_using_the_2005_2008_Medical_Expenditure_Panel_Survey_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0161-4754(12)00160-1 DB - PRIME DP - Unbound Medicine ER -