Cost effectiveness of physiotherapy, manual therapy, and general practitioner care for XXXX : economic evaluation alongside a randomised controlled trial.

@entity1 @entity4048 @entity7634 @entity158
OBJECTIVE: To evaluate the cost effectiveness of physiotherapy, manual therapy, and care by a general practitioner for @entity1 with @entity4048 . DESIGN: Economic evaluation alongside a randomised controlled trial. SETTING: Primary care. @entity1 : 183 @entity1 with @entity4048 for at least two weeks recruited by 42 general practitioners and randomly allocated to manual therapy (n=60, spinal mobilisation), physiotherapy (n=59, mainly exercise), or general practitioner care (n=64, counselling, education, and drugs). MAIN OUTCOME MEASURES: Clinical outcomes were perceived recovery, intensity of @entity158 , and quality of life. Direct and indirect costs were measured by means of cost diaries that were kept by @entity1 for one year. Differences in mean costs between groups, cost effectiveness, and cost utility ratios were evaluated by applying non-parametric bootstrapping techniques. RESULTS: The manual therapy group showed a faster improvement than the physiotherapy group and the general practitioner care group up to 26 weeks, but differences were negligible by follow up at 52 weeks. The total costs of manual therapy (447 @entity7634 ; 273 pounds sterling; 402 dollars) were around one third of the costs of physiotherapy (1297 @entity7634 ) and general practitioner care (1379 @entity7634 ). These differences were significant: P<0.01 for manual therapy versus physiotherapy and manual therapy versus general practitioner care and P=0.55 for general practitioner care versus physiotherapy. The cost effectiveness ratios and the cost utility ratios showed that manual therapy was less costly and more effective than physiotherapy or general practitioner care. CONCLUSIONS: Manual therapy (spinal mobilisation) is more effective and less costly for treating @entity4048 than physiotherapy or care by a general practitioner.
