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Legorreta and colleagues¹ suggested that open access to chiropractic care could decrease health care expenditures for neuromusculoskeletal disorders because a chiropractor would be used as a substitute for traditional care, not as an add-on. They concluded that access to managed chiropractic care may be clinically beneficial. I believe, however, that this statement should not be made before 2 important questions are satisfactorily answered.

First, is access to chiropractor care independently associated with a lower cost? Patients in the 2 groups are extremely different: those without chiropractor coverage are older and sicker. The authors, however, try to compare the incomparable by summing up 21 comorbid conditions that are much more prevalent (19 parameters at P<.001) among those without chiropractor coverage into 1 comorbidity score, rather than adjusting for them one by one. Besides, they ignore other characteristics associated with increased cost including functional status and disability index (one can always . . . [Full Text of this Article]

AUTHOR INFORMATION
Tawee Tanvetyanon, MD

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