Clinical and Cost Outcomes of an Integrative Medicine IPA
Sarnat, Richard,M.D., Winterstein, D.C. “Clinical and Cost Outcomes of an Integrative Medicine IPA”. J Manipulative Physiol Ther 2004,:27:336-47.
This is the first study to analyze the clinical outcomes of a group of patients using doctors of chiropractic as Primary Care Physicians (PCPs) or “gatekeepers” and compare the costs and outcomes with another group using conventional allopathic PCPs. The theory that those chiropractic PCPs utilizing an integrative approach would have substanially improved clinical outcomes and decreased health care costs was proven. The greatest health care system burden, as the population ages, is the prevention and treatment of the multiple chronic disorders. In addition, Iatrogenic Disease (an adverse condition arising from treatment) is estimated at 15% of all hospital admissions and pharmaceuticals are estimated to cause between 100,000 and 250,000 deaths per year. This study emerged out of the need to rethink this country’s current medical model with it’s overreliance on drugs as a first line of defense. Complimentary/Alternative medicine (CAM) is a viable option, as this study demonstrates, because it addresses the quality and expense considerations facing our system today. The analysis of clinical and cost outcomes on 21,743 member months over a 4- year period demonstrated significant decreases of 43% in hospital admissions per 1000, 58% hospital days per 1000, 43.2% outpatient surgeries and procedures per 1000, and 51.8% pharmaceutical cost reductions when compared with normative conventional medicine IPA performance for the same HMO product in the same geography over the same time. Although this pioneer study was performed with a limited population, the results were so encouraging that it may represent a new model of health care delivery.