Clinical Utilization and Cost Outcomes From an Integrative Medicine Independent Physician Association: An Additional 3-Year Update

Clinical Utilization and Cost Outcomes From an Integrative Medicine Independent Physician Association: An Additional 3-Year Update
June 12, 2007
The Week in Chiropractic

Objective
Our initial report analyzed clinical and cost utilization data from the years 1999 to 2002 for an integrative medicine independent physician association (IPA) whose primary care physicians (PCPs) were exclusively doctors of chiropractic. This report updates the subsequent utilization data from the IPA for the years 2003 to 2005 and includes first-time comparisons in data points among PCPs of different licensures who were oriented toward complementary and alternative medicine (CAM).

Methods
Independent physician associationÒincurred claims and stratified random patient surveys were descriptively analyzed for clinical utilization, cost offsets, and member satisfaction compared with conventional medical IPA normative values. Comparisons to our original publication's comparative blinded data, using nonrandom matched comparison groups, were descriptively analyzed for differences in age/sex demographics and disease profiles to examine sample bias.

Results
Clinical and cost utilization based on 70274 member-months over a 7-year period demonstrated decreases of 60.2% in-hospital admissions, 59.0% hospital days, 62.0% outpatient surgeries and procedures, and 85% pharmaceutical costs when compared with conventional medicine IPA performance for the same health maintenance organization product in the same geography and time frame.

Conclusion
During the past 7 years, and with a larger population than originally reported, the CAM-oriented PCPs using a nonsurgical/nonpharmaceutical approach demonstrated reductions in both clinical and cost utilization when compared with PCPs using conventional medicine alone. Decreased utilization was uniformly achieved by all CAM-oriented PCPs, regardless of their licensure. The validity and generalizability of this observation are guarded given the lack of randomization, lack of statistical analysis possible, and potentially biased data in this population

Sarnat RL, et al. Journal of Manipulative and Physiological Therapeutics. May 2007; Vol. 30, Iss. 4, pp. 263-269.
----------------------------------------------------------------------
Inclusion of information in The Week in Chiropractic does not imply endorsement from FCER nor does inclusion imply agreement with FCERÌs views.
For a complete copy of an article abstracted in "Research Review," please check your local medical or chiropractic college library. Articles may also be ordered from FCERÌs Literature Search Service at 800-743-3282.
Copyright 2007 Foundation for Chiropractic Education and Research
You can reprint any part of this newsletter with the following attribution: ÏReprinted with permission of the Foundation for Chiropractic Education and Research, The Week in Chiropractic. Subscribe for free at www.fcer.org.
FCER Members can now access the Manual and Alternative Natural Therapy Index System (MANTIS) database for FREE. For more informationÛincluding Account number and Password (required for access to MANTIS)Ûplease call FCER at 800-637-6244, or send a request for information to FCER@fcer.org. Not a member? Find out how at www.FCER.org. ----------------------------------------------------------------------
The Week in Chiropractic is a weekly e-mail newsletter published by the Foundation for Chiropractic Education and Research, PO Box 400, 380 Wright Rd, Norwalk, IA 50211, Tele: 800-622-6309, Fax: 515-981-9427, E-mail FCER@fcer.org. Send editorial correspondence to Robin R. Merrifield, Editor, 1304 Perry Ave, Bremerton, WA 98310. E-mail: FCERedit@aol.com.
----------------------------------------------------------------------
Visit FCER's web site at www.FCER.org