Utilization of manipulative treatment for spine and shoulder conditions between different medical providers in a large military hospital

Publication date: Available online 14 July 2017
Source:Archives of Physical Medicine and Rehabilitation
Author(s): Daniel Rhon, Tina Greenleee, Julie Fritz
ObjectiveDescribe the use of manipulative treatment for shoulder and spine conditions between various provider types.DesignRetrospective observational cohortSettingSingle military hospitalParticipantsConsecutive sample of 7,566 patients seeking care for an initial spine or shoulder condition from 1 January to 31 December 2009.InterventionsManipulative treatment (e.g. manual therapy, spinal and joint manipulation, etc).Main Outcome MeasureManipulation treatment was identified with procedure billing codes in medical records. Spine and shoulder conditions were identified by use of International Classification of Diseases, 9th edition codes. All data were abstracted from the Department of Defense Military Health System Management and Analysis Tool.ResultsOf 7,566 total patients seeking care, 2,014 (26.6%) received manipulative treatment at least once, and 1870 of those received this treatment in a military facility (24.7%). Manipulative treatment was utilized most often for thoracic and least often for shoulder conditions (50.8% and 24.2% of all patients). There was a total of 6,706 unique medical visits with a manipulative treatment procedure (average of 3.3 manipulative treatment procedure visits per patient).ConclusionsManipulative treatment utilization rates for shoulder and spine conditions ranged from 26.6% to 50.2%. Chiropractors utilized manipulation the most, and physical therapists the least.



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