Impact of Chiropractic Services at an On-Site Health Center



Description Chiropractic spinal adjustment.jpg

Journal of Occupational and Environmental Medicine
September 2014; Volume 56; No. 9; pp. 990–992

Sylvia L. Kindermann, MPH; Qingjiang Hou, MS; Ross M. Miller, MD, MPH
The objective of this study was to compare the influence of employer-sponsored,
on-site chiropractic care against community-obtained care on health care utilization.
It was a retrospective claims analysis study, using 876 on-site and 759 off-site
1) Musculoskeletal conditions are the primary cause of physical disability in the
United States.
2) About 50% of US adults have back pain, arthritis, osteoporosis, or bodily
injury in excess of 3 months’ duration annually.
3) 17% of US workers have absenteeism as a result of musculoskeletal
conditions yearly.
4) Neck pain inhibits about 14% of workers from successfully completing their
5) In 2006, the average direct cost of treatment for musculoskeletal conditions
was $576 billion, and indirect costs added an additional $373 billion, primarily in
wage losses. [total = $949 billion]
6) “Doctors of chiropractic promote wellness and injury prevention.”
7) “Chiropractic care has been demonstrated to deliver effective treatment for
the symptoms of musculoskeletal conditions.”
8) “On-site chiropractic care has been shown to deliver substantial value through convenience of access, high quality of care and delivery, and lowered overall costs.”
9) On-site chiropractic care has “demonstrated significant improvements in
headache, neck pain, and low back pain functional status in patients utilizing on-site
services over a short time frame while still showing lower utilization and cost
outcomes than community-based care.”
10) Employer-sponsored worksite clinics could control costs and increase
workplace productivity while providing high quality and convenient care to their
11) “This study demonstrates that users of on-site chiropractic services have
lower health care utilization than those who obtain their care at off-site community
care centers.”
12) “Patients receiving chiropractic care on-site were significantly less likely to
have radiology [diagnostic imaging, including MRI, ultrasound, and x-rays] testing.”
13) The off-site group received more radiology services overall (55.5% vs 38.2%)
including magnetic resonance imaging, ultrasound, and radiograph; had higher
outpatient and emergency department utilization; and demonstrated greater use of
chiropractic care and physical therapy.
14) “The mean number of chiropractic services and physical therapy visits per
member were both significantly higher in the off-site group.”
15) “The results of this study support the value of chiropractic services offered at
on-site health centers in comparison with chiropractic services provided off-site.
Future research into potential indirect and direct cost savings would supplement
this study and further demonstrate the advantages of on-site chiropractic care.”

16) “Compared with off-site care, on-site chiropractic services are associated with
lower health care utilization. These results support the value of chiropractic services
offered at on-site health centers.”
[numbers rounded] On-Site Chiropractic
Off-site Chiropractic
Diagnostic Imaging
(X-ray, MRI,
38% 56%
(X-ray) 27% 46%
(MRI) 12% 15%
(Ultrasound) 11% 16%
Repeated Diagnostic
19% 30%
Outpatient Utilization 30% 47%
Emergency Department
13% 19%


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