Trends in the Use and Characteristics of Chiropractic Services in the Department of Veterans Affairs.
The purpose of this study was to analyze national trends and key features of the Department of Veterans Affairs' (VA's) chiropractic service delivery and chiropractic provider workforce since their initial inception.



This was a serial cross-sectional analysis of the VA administrative data sampled from the first record of chiropractic services in VA through September 30, 2015. Data were obtained from VA's Corporate Data Warehouse and analyzed with descriptive statistics.



From October 1, 2004, through September 30, 2015, the annual number of patients seen in VA chiropractic clinics increased from 4052 to 37349 (821.7%), and the annual number of chiropractic visits increased from 20072 to 159366 (693.9%). The typical VA chiropractic patient is male, is between the ages of 45 and 64, is seen for low back and/or neck conditions, and receives chiropractic spinal manipulation and evaluation and management services. The total number of VA chiropractic clinics grew from 27 to 65 (9.4% annually), and the number of chiropractor employees grew from 13 to 86 (21.3% annually). The typical VA chiropractor employee is a 45.9-year-old man, has worked in VA for 4.5 years, and receives annual compensation of $97860. VA also purchased care from private sector chiropractors starting in 2000, growing to 159533 chiropractic visits for 19435 patients at a cost of $11155654 annually.



Use of chiropractic services and the chiropractic workforce in VA have grown substantially over more than a decade since their introduction.
Chiropractic Section Chief, VA Connecticut Healthcare System, West Haven, CT; Assistant Clinical Professor, Yale Center for Medical Informatics, Yale University School of Medicine, New Haven, CT. Electronic address: Anthony.lisi@va.gov.
Anthony J
AJ
Lisi
Staff Physician, VA Connecticut Healthcare System, West Haven, CT; Professor, Yale Center for Medical Informatics, Yale University School of Medicine, New Haven, CT.
Cynthia A
CA
Brandt
D000328:Adult; D003430:Cross-Sectional Studies; D017598:Efficiency, Organizational; D006787:Hospitals, Veterans / Q000639:trends*; D006801:Humans; D008297:Male; D026882:Manipulation, Chiropractic / Q000639:trends*; D008875:Middle Aged; D011787:Quality of Health Care; D012017:Referral and Consultation / Q000639:trends; D014481:United States; D014493:United States Department of Veterans Affairs / Q000639:trends; D014728:Veterans / Q000706:statistics & numerical data*
Chiropractic; Health Services; Veterans Administration