The Windsor Studies

------------------------------------------------------------------------------- The RAND Study THE MOST COMMONLY USED CONSERVATIVE TREATMENT A 1991 comprehensive report on a study conducted by the prestigious RAND Corporation was conducted by Paul Shekelle, MD, MPH, and internist on the faculty of UCLA. Among other important findings, the report stated that: “Spinal manipulation is the most commonly used conservative treatment for back pain supported by the most research evidence of effectiveness in terms of early results and long-term effectiveness.” This project is an ongoing joint venture of RAND, the UCLA Department of Medicine, the Consortium for Chiropractic Research, the Foundation for Chiropractic Education and Research and Value Health Sciences, Inc. The Rand panel of researchers consisted of two orthopedists, one osteopath, one internist, one family physician, three chiropractors and one health practitioner with both medical and chiropractic degrees.

-------------------------------------------------------------------------------- The British Study MORE EFFECTIVE WITH LONGER-LASTING BENEFITS A study conducted by Thomas Meade, MD, reported in the acclaimed British Medical Journal (1990), compared chiropractic and medical management of patients' low back pain. This was by far the most thorough trial ever performed in the field of back pain. The report stated: “Patients treated by chiropractors... almost certainly fared considerably better and maintained their improvement for at least two years.” Potential economic policy implications are that if chiropractic were fully integrated into the British health system there might be a reduction of some 290,000 days in sickness during two years, saving about 13 million pounds in output and 2.9 million pounds in social security payments. A second study has since been published confirming the results of this research.

-------------------------------------------------------------------------------- The MEDSTAT Project CHIROPRACTIC INCLUSION PROVIDES SIGNIFICANT SAVINGS MEDSTAT is an independent study of the cost of treating many common neuro-musculoskeletal conditions conducted recently under the direction of Miron Stano, Ph.D., a health care economist and Professor at the School of Business, Oakland University, Rochester, MI. The database developed for this study contained data on over 2 million beneficiaries in the fee-for-service sector, making it the largest known source of private-sector information on chiropractic claims payments. The database contained claims for 396,000 patients, including 93,000 chiropractic patients, with data from medical and chiropractic claims for 493 diagnostic codes. Payment comparisons are consistent with the view that chiropractic substitutes for other forms of care. Overall, the group receiving medical treatment only, has mean insurance payments 30% higher than the group receiving both chiropractic and medical care. COMPARISON OF HOSPITAL ADMISSIONS RATES Rate of hospital admissions (MD-DO Patient) 29% Rate of hospital admissions (DC Patient) 19%

-------------------------------------------------------------------------------- The Canadian Report SAFER AND MORE EFFECTIVE A new report says that hundreds of millions of dollars can be saved by transferring management of low back pain to chiropractors. Widely known as the Manga Report after health economist Pran Manga, Ph.D., the study's conclusions are remarkable in their support of chiropractic care over traditional medical care for low back pain. In fact, the report recommends that chiropractors be consulted first, as the gatekeepers for treatment of low back pain for cost-effective treatment. Funded by the Ontario Ministry of Health, this report establishes the superiority of chiropractic spinal manipulation over the use of drugs, surgery, bed rest and various physical therapy procedures in treating low back pain. Excerpts from the report follow: On efficacy... “...spinal manipulation applied by chiropractors is shown to be more effective than alternative treatments for low back pain.” On safety... “...the literature suggests that it (chiropractic) is not only very safe but much safer than medical and other professional management of low back pain.” On medical research... “It is surprising to discover how 'unscientific' traditional medical therapies for low back pain are, and further, how slowly clinical research affects actual medical practice. Most low back surgery is not founded on evidence from randomized or even non-randomized trials.” Recommendations... “In our view, the constellation of evidence offers an overwhelming case in favor of much greater use of chiropractic services for the management of low back pain... A very good case can be made for making chiropractors gatekeepers for management of low back pain in the workers' compensation system in Ontario.” Other chiropractic benefits... “In our review we came across many studies that support the effectiveness of chiropractic care for headache and migraine, neck pain and referred and radiating pain, an a variety of other ailments.”

-------------------------------------------------------------------------------- The Utah Study CHIROPRACTIC PATIENTS RETURN TO WORK TEN TIMES SOONER AT TEN TIMES LESS COST A 1991 study of workers' compensation claims comparing medical care to chiropractic care and reported in The Journal of Occupational Medicine found that chiropractic patients return to work ten times sooner after and injury. An interesting quote from the article was: “For the total data set, cost for care was significantly more for medical claims and compensation costs were ten-fold less for chiropractic claims.” ICD-9 CODES TOTAL COST (MEDICAL) TOTAL COST (CHIROPRACTIC)

-------------------------------------------------------------------------------- Lumbar Disc $8,175 $1,065 Neuritis/Radiculitis $2,154 $531 Sprain/Sacroiliac $813 $537 Sprain/Strain Cervical $968 $586 Sprain/Strain Thoracic $487 $474 Sprain/Strain Lumbar $959 $523

-------------------------------------------------------------------------------- Total cost of selected cases $13,556 $3,716 Average cost per case $2,259 $619 This study is important because it involved 3,062 separate injury cases. The sample consisted of 40.6% of the 7,551 estimated back injury claims from the 1986 Workers' Compensation Fund of Utah.

-------------------------------------------------------------------------------- Western Journal of Medicine CHIROPRACTIC PATIENTS REPORT GREATER SATISFACTION THAN MEDICAL PATIENTS Patient Satisfaction Medical Patients Chiropractic Patients Very satisfied with care 22% 66% Doctor seemed confident about back pain diagnosis 23% 61% Feel doctor concerned about them 20% 58% Experienced restricted activity for less than one week 52% 83% A study reported in the March 1989 issue of the respected Western Journal of Medicine compared satisfaction of chiropractic and medical patients from Group Health Cooperative, a large Seattle HMO.

Researchers there found that low back pain patients evaluated their chiropractic doctors highly in critical patient care areas while medical doctors received much lower marks. Patients generally gave chiropractors a three-to-one advantage in five important areas of satisfaction. Chiropractic patients in the study also reported quicker recoveries.

-------------------------------------------------------------------------------- Notable Quotes from Current Literature “Chiropractors appear to be well trained and well accepted by both patients and insurers.” -- Journal of Family Practice “Plans which do not cover chiropractic have the highest payments per patient.” -- Journal of American Health Policy