Temporal Trends and Geographic Variations in the Supply of Clinicians Who Provide Spinal Manipulation to Medicare Beneficiaries: A Serial Cross-Sectional Study.
J Manipulative Physiol Ther
; 44(3): 177-185, 2021 03.
Article
en En
| MEDLINE
| ID: mdl-33849727
ABSTRACT
OBJECTIVE:
Spinal manipulation (SM) is recommended for first-line treatment of patients with low back pain. Inadequate access to SM may result in inequitable spine care for older US adults, but the supply of clinicians who provide SM under Medicare is uncertain. The purpose of this study was to measure temporal trends and geographic variations in the supply of clinicians who provide SM to Medicare beneficiaries.METHODS:
Medicare is a US government-administered health insurance program that provides coverage primarily for older adults and people with disabilities. We used a serial cross-sectional design to examine Medicare administrative data from 2007 to 2015 for SM services identified by procedure code. We identified unique providers by National Provider Identifier and distinguished between chiropractors and other specialties by Physician Specialty Code. We calculated supply as the number of providers per 100â¯000 beneficiaries, stratified by geographic location and year.RESULTS:
Of all clinicians who provide SM to Medicare beneficiaries, 97% to 98% are doctors of chiropractic. The geographic supply of doctors of chiropractic providing SM services in 2015 ranged from 20/100â¯000 in the District of Columbia to 260/100â¯000 in North Dakota. The supply of other specialists performing the same services ranged from fewer than 1/100â¯000 in 11 states to 8/100â¯000 in Colorado. Nationally, the number of Medicare-active chiropractors declined from 47â¯102 in 2007 to 45â¯543 in 2015. The count of other clinicians providing SM rose from 700 in 2007 to 1441 in 2015.CONCLUSION:
Chiropractors constitute the vast majority of clinicians who bill for SM services to Medicare beneficiaries. The supply of Medicare-active SM providers varies widely by state. The overall supply of SM providers under Medicare is declining, while the supply of nonchiropractors who provide SM is growing.Palabras clave
Texto completo:
1
Bases de datos:
MEDLINE
Asunto principal:
Medicare
/
Dolor de la Región Lumbar
/
Manipulación Espinal
/
Manipulación Quiropráctica
Tipo de estudio:
Observational_studies
/
Prevalence_studies
/
Risk_factors_studies
Límite:
Aged
/
Humans
/
Male
País/Región como asunto:
America do norte
Idioma:
En
Revista:
J Manipulative Physiol Ther
Año:
2021
Tipo del documento:
Article