Hurwitz Eric L, Chiang Lu-May
Department of Public Health Sciences and Epidemiology, John A. Burns School of Medicine, University of Hawaii-Manoa, Biomed, D-104H, Honolulu, Hawaii 96822, USA.
BMC Health Serv Res. 2006 Apr 6;6:49. doi: 10.1186/1472-6963-6-49.
Scientifically rigorous general population-based studies comparing chiropractic with primary-care medical patients within and between countries have not been published. The objective of this study is to compare care seekers of doctors of chiropractic (DCs) and general practitioners (GPs) in the United States and Canada on a comprehensive set of sociodemographic, quality of life, and health-related variables.
Data are from the Joint Canada/U.S. Survey of Health (JCUSH), 2002-03, a random sample of adults in Canada (N = 3505) and the U.S. (N = 5183). Respondents were categorized according to their pattern of health-care use in the past year. Distributions, percentages, and estimates (adjusted odds ratios) weighted to reflect the complex survey design were produced.
Nearly 80% of respondents sought care from GPs; 12% sought DC care. Compared with GP only patients, DC patients in both countries tend to be under 65 and white, with arthritis and disabling back or neck pain. U.S. DC patients are more likely than GP only patients to be obese and to lack a regular doctor; Canadian DC patients are more likely than GP only patients to be college educated, to have higher incomes, and dissatisfied with MD care. Compared with seekers of both GP and DC care, DC only patients in both countries have fewer chronic conditions, take fewer drugs, and have no regular doctor. U.S. DC only patients are more likely than GP+DC patients to be uninsured and dissatisfied with health care; Canadian DC only patients are more likely than GP+DC patients to be under 45, male, less educated, smokers, and not obese, without disabling back or neck pain, on fewer drugs, and lacking a regular doctor.
Chiropractic and GP patients are dissimilar in both Canada and the U.S., with key differences between countries and between DC patients who do and do not seek care from GPs. Such variation has broad and potentially far-reaching health policy and research implications.
尚未发表基于科学严谨性、以普通人群为基础、在国家内部和国家之间比较整脊疗法与初级保健医疗患者的研究。本研究的目的是在美国和加拿大，就一系列全面的社会人口统计学、生活质量和健康相关变量，比较整脊疗法医生（DC）和全科医生（GP）的求医者。
数据来自2002 - 2003年加拿大/美国健康联合调查（JCUSH），这是对加拿大（N = 3505）和美国（N = 5183）成年人的随机抽样。受访者根据其过去一年的医疗保健使用模式进行分类。生成了经加权以反映复杂调查设计的分布、百分比和估计值（调整后的优势比）。
近80%的受访者寻求全科医生的治疗；12%寻求整脊疗法治疗。与仅看全科医生的患者相比，两国的整脊疗法患者往往年龄在65岁以下且为白人，患有关节炎以及背部或颈部疼痛致残。美国的整脊疗法患者比仅看全科医生的患者更有可能肥胖且没有固定医生；加拿大的整脊疗法患者比仅看全科医生的患者更有可能受过大学教育、收入更高且对西医治疗不满意。与同时寻求全科医生和整脊疗法治疗的患者相比，两国仅看整脊疗法的患者慢性病更少、用药更少且没有固定医生。美国仅看整脊疗法的患者比同时看全科医生和整脊疗法的患者更有可能未参保且对医疗保健不满意；加拿大仅看整脊疗法的患者比同时看全科医生和整脊疗法的患者更有可能年龄在45岁以下、为男性、受教育程度较低、吸烟、不肥胖、没有背部或颈部疼痛致残、用药较少且没有固定医生。
在加拿大和美国，整脊疗法患者和全科医生患者存在差异，两国之间以及寻求和不寻求全科医生治疗的整脊疗法患者之间存在关键差异。这种差异对健康政策和研究具有广泛且可能影响深远的意义。
