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A longitudinal study of chiropractic use among older adults in the United States
Journal article   Open access   Peer reviewed

A longitudinal study of chiropractic use among older adults in the United States

Paula Weigel, Jason Hockenberry, Suzanne Bentler, Maksym Obrizan, Brian Kaskie, Michael Jones, Robert Ohsfeldt, Gary Rosenthal, Robert Wallace and Fredric Wolinsky
Chiropractic & osteopathy, Vol.18(1), pp.34-34
2010
DOI: 10.1186/1746-1340-18-34
PMCID: PMC3019203
PMID: 21176137
url
https://doi.org/10.1186/1746-1340-18-34View
Published (Version of record) Open Access

Abstract

We analyzed data from two linked sources: the baseline (1993-1994) interview responses of 5,510 self-respondents in the Survey on Assets and Health Dynamics Among the Oldest Old (AHEAD), and their Medicare claims from 1993 to 2007. Binomial logistic regression was used to identify factors associated with chiropractic use versus nonuse, and conditional upon use, to identify factors associated with high volume relative to lower volume use.There were 806 users of chiropractic in the AHEAD sample yielding a full period prevalence for 1993-2007 of 14.6%. Average annual prevalence between 1993 and 2007 was 4.8% with a range from 4.1% to 5.4%. Approximately 42% of the users consumed chiropractic services only in a single calendar year while 38% used chiropractic in three or more calendar years. Chiropractic users were more likely to be women, white, overweight, have pain, have multiple comorbid conditions, better self-rated health, access to transportation, higher physician utilization levels, live in the Midwest, and live in an area with fewer physicians per capita. Among chiropractic users, 16% had at least one year in which they exceeded Medicare's "soft cap" of 12 visits per calendar year. These over-the-cap users were more likely to have arthritis and mobility limitations, but were less likely to have a high school education. Additionally, these over-the-cap individuals accounted for 58% of total chiropractic claim volume. High volume users saw chiropractors the most among all types of providers, even more than family practice and internal medicine combined.There is substantial heterogeneity in the patterns of use of chiropractic services among older adults. In spite of the variability of use patterns, however, there are not many characteristics that distinguish high volume users from lower volume users. While high volume users accounted for a significant portion of claims, the enforcement of a hard cap on annual visits by Medicare would not significantly decrease ove

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