Mior Silvano A, Laporte Audrey
Division of Research, Canadian Memorial Chiropractic College, Toronto, Canada.
J Manipulative Physiol Ther. 2008 Feb;31(2):104-14. doi: 10.1016/j.jmpt.2007.12.007.
Chiropractic is one of the most frequently sought nonphysician provider groups. Despite its apparent recognition, the profession faces numerous challenges, including the economic reality of an increasing supply within a market of questionable demand. This paper evaluates the chiropractic manpower status in Ontario, Canada.
Data collected from administrative and education databases, insurance billing data, and population health survey data between 1990 and 2004 were analyzed.
Between 1990 and 2004, the total number of chiropractic registrants in Ontario doubled, with an average annual rate of growth of about 5.4%; however, recent data suggest that the number of nonpracticing chiropractors is increasing, whereas the number of new registrants is decreasing. The rate of applications to a chiropractic institution rose sharply and peaked in 1996-1997, thereafter declining but leveling off in 2002-2003. Despite the continued growth in the number of practicing chiropractors, the utilization of chiropractic services among the Ontario population has remained relatively stable, resulting in a decline in the average net annual incomes adjusted for inflation to 2002 dollars.
Our results support previous reports projecting an oversupply of chiropractors and suggest that the chiropractic profession in Ontario is in long-run oversupply. Competition from other providers, changing population demographics, and the recent loss of public funding for services may present significant future challenges to current practitioners. Opportunities related to participation in multidisciplinary environments and accessing unmet population health needs may contribute to influencing the demand for chiropractic services. A concerted effort by professional and educational institutions is required.
整脊疗法是最常被寻求的非医师医疗服务群体之一。尽管其已得到明显认可，但该行业仍面临诸多挑战，包括在需求存疑的市场中供应不断增加这一经济现实。本文评估了加拿大安大略省的整脊疗法人力状况。
分析了1990年至2004年间从行政和教育数据库、保险计费数据以及人口健康调查数据中收集的数据。
1990年至2004年间，安大略省整脊疗法注册人员总数翻了一番，年均增长率约为5.4%；然而，近期数据表明，未执业的整脊疗法从业者数量在增加，而新注册人员数量在减少。申请进入一所整脊疗法机构的比率急剧上升，并在1996 - 1997年达到峰值，此后下降，但在2002 - 2003年趋于平稳。尽管执业整脊疗法从业者数量持续增长，但安大略省人群对整脊疗法服务的利用率一直相对稳定，导致经通胀调整至2002年美元价值的平均年净收入下降。
我们的结果支持了先前有关整脊疗法从业者供应过剩的报告，并表明安大略省的整脊疗法行业长期处于供应过剩状态。来自其他医疗服务提供者的竞争、不断变化的人口结构以及近期公共服务资金的流失，可能给当前从业者带来重大的未来挑战。参与多学科环境以及满足未得到满足的人群健康需求相关的机遇，可能有助于影响对整脊疗法服务的需求。专业机构和教育机构需要共同努力。
