Chiropractic Care – Contributing to a Safer, More Clinically Sustainable New Zealand Health Service

Chiropractors are poised to play a vital part in the country’s primary health care system, according to the New Zealand Chiropractors’ Association (NZCA). In its submission to the Government’s New Zealand Health Strategy Update, the NZCA says that chiropractors are well placed to deliver high quality, evidence-based, natural and non-surgical care to manage neuromusculoskeletal dysfunction.

Dr Hayden Thomas, chiropractor and spokesperson for the NZCA explains: `A key premise of chiropractic care is to promote health and wellbeing. As such the chiropractic profession is ideally placed to support New Zealanders to “live well, get well and stay well” also a key objective of the New Zealand Government’s Health Strategy Update.

`Neuromusculoskeletal (NMSK) disorders (problems with nerves, muscles and skeletal structure of the body, primarily of the spine) place a heavy burden on the New Zealand health service and have become increasingly costly. This cost goes well beyond the healthcare sector, placing a strain on industry due to lost productivity (presenteeism) and days away from work (absenteeism), and for the individual, a reduction in ability to perform activities of daily living and ultimately their quality of life.’ 

●      UK figures estimate that up to 30% of all GP consultations are about musculoskeletal complaints and British GPs have reported that it is the top clinical reason for visits (with musculoskeletal pain the most common presenting symptom) (Department of Health, 2006. Musculoskeletal Services Framework)

●      NMSK conditions have a significant social and economic impact, with up to 60% of people who are on long-term sick leave citing NMSK problems as the reason and patients with NMSK forming the second largest group (22%) receiving incapacity benefits. (CBI, in association with AXA, 2005. ‘Who care wins: absence and labour turnover 2005’)

●      Furthermore, it is recognised that whilst prevalent in all age groups the incidence of NMSK disorders generally rises with age. As such the age and proportion of older ages in the population will further increase the demand for NMSK services on an already overloaded public system.

 

Traditionally, public funded treatment for these disorders has been confined to hospital outpatient departments, however the NZCA believes that broadening the choice of provider of NMSK services for spinal dysfunction (including back and neck pain), to fully incorporate chiropractic care will drive up quality, reduce cost and enable innovation. Chiropractic care has routinely been shown to be safe, effective and has a very high patient satisfaction rate.^1-13

The current New Zealand Health Strategy was published in 2000 and much has changed since then, especially growing research into the role of chiropractic care in the management of spinal dysfunction. The updated strategy will set a new vision and a road map for the next three to five years for the health sector.

Dr Thomas says: `We know we can contribute to a high quality health system that integrates across the social sector and is sustainable in the long term. Chiropractic in New Zealand is increasingly focused on providing a foundation for a safer and more clinically and financially sustainable health sector.’

New Zealand has a world renown chiropractic training facility, The New Zealand College of Chiropractic. The college also has a growing internationally acclaimed research centre that is performing and publishing cutting edge studies into the beneficial effect chiropractic care is having on the NMSK system and positive outcomes for the restoration and preservation of health, function and general wellbeing.

NZCA chiropractors provide care with a patient centred, whole person and functional outcome focus. The care is tailored to the individual including a recognition of various biopsychosocial factors that may be involved. They support their hands-on care with cognitive interventions such as individual counselling and advice about the patient's lifestyle, work, and exercise, in order to help manage the condition and prevent it from recurring. Chiropractors have a proud history and grounding in the advantages of a maintenance, prevention and wellness based approach.

For further information on the New Zealand Chiropractors’ Association visit www.chiropractic.org.nz. 

-Ends-

 

 

Further Information:

 

Dr Hayden Thomas, Chiropractor 027 299 9939 or hayden@chiropractic.org.nz

 

Peter Boyes 027 554 0500 or peter@boyespr.co.nz

 

 

References:

 

1.     Rubinstein SM. Adverse events following chiropractic care for subjects with neck or low-back pain: do the benefits outweigh the risks? J Manipulative Physiol Ther. Jul-Aug 2008;31(6):461-464.

2.     Carnes D, Mars TS, Mullinger B, Froud R, Underwood M. Adverse events and manual therapy: A systematic review. Man Ther. 2010;15(4):355-363.

3.     Bronfort G, Haas M, Evans RL, Bouter LM. Efficacy of spinal manipulation and mobilization for low back pain and neck pain: a systematic review and best evidence synthesis. Spine Journal: Official Journal of the North American Spine Society. May-Jun 2004;4(3):335-356.

4.     Gaumer G. Factors associated with patient satisfaction with chiropractic care: survey and review of the literature. J Manipulative Physiol Ther. Jul-Aug 2006;29(6):455-462.

5.     Walker BF, French SD, Grant W, Green S. A Cochrane review of combined chiropractic interventions for low-back pain. Spine (Phila Pa 1976). Feb 1 2011;36(3):230-242.

6.     Haas M, Sharma R, Stano M. Cost-effectiveness of medical and chiropractic care for acute and chronic low back pain. J Manipulative Physiol Ther. Oct 2005;28(8):555-563.

7.     Rafter N, Hickey A, Condell S, et al. Adverse events in healthcare: learning from mistakes. QJM. Jul 29 2014.

8.      "Spinal manipulation epidemiology: Systematic review of cost effectiveness studies". J Electromyogr Kinesiol 22 (5): 655–62.doi:10.1016/j.jelekin.2012.02.011. PMID22429823.). 

9.      "Cost-effectiveness of guideline-endorsed treatments for low back pain: a systematic review". European Spine Journal20 (7): 1024–1038. doi:10.1007/s00586-010-1676-3. PMC3176706. PMID21229367)

10.   (Mootz RD, Hansen DT, Breen A, Killinger LZ, Nelson C (2006). "Health services research related to chiropractic: review and recommendations for research prioritization by the chiropractic profession". J Manipulative Physiol Ther 29 (9): 707–25. doi:10.1016/j.jmpt.2006.09.001.PMID17142165)

11.    (Phelan SP, Armstrong RC, Knox DG, Hubka MJ, Ainbinder DA. An evaluation of medical and chiropractic provider utilization and costs: treating injured workers in North Carolina. J Manipulative Physiol Ther. Sep 2004;27(7):442-448).

12.   "Clinical Utilization and Cost Outcomes From an Integrative Medicine Independent Physician Association: An Additional 3-Year Update".Journal of Manipulative and Physiological Therapeutics 30 (4): 263–269.doi:10.1016/j.jmpt.2007.03.004. PMID17509435)

13.   http://www.nhsalliance.org/press-releases/article/date/2009/10/nhs-allianceannounces-the-2009-acorn-award-winners/ and has subsequently been used as a case study by the Department of Health http://healthandcare.dh.gov.uk/backand-neck-pain-services/