一项基于社区的脊椎按摩疗法服务使用情况研究。
A community-based study of the use of chiropractic services.
作者信息
Shekelle P G, Brook R H
机构信息
Department of Medicine, University of California Los Angeles 90024.
出版信息
Am J Public Health. 1991 Apr;81(4):439-42. doi: 10.2105/ajph.81.4.439.
BACKGROUND
Little population-based information is available on the use of chiropractic services.
METHODS
We analyzed data from the RAND Health Insurance Experiment (HIE), a community-based study of the use of health services. Insurance claim forms for all fee-for-service patients who completed the study were examined for all visits coded as being seen by a chiropractor. Services provided and patient-specified symptoms were taken from these forms. Population-based use rates were calculated for each HIE site. Use rates and services were calculated separately for first visits and repeat visits.
RESULTS
There were 5,279 persons who contributed 19,021 person-years of exposure during the study; 395 different persons used 7,873 chiropractic services for a visit rate of 41 per 100 person-years and rate of use of 7.5 percent. Forty-two percent of all visits were for pain in the back. Spinal manipulation accounted for 61 percent of all services provided. Compared to non-users, users tended to be White, middle-aged, married, and high school educated. Seven-fold geographic variations in the use of chiropractic services were seen.
CONCLUSIONS
Chiropractors deliver a substantial amount of health care to the US population, and there are significant geographic variations in the rate and intensity of use of chiropractic services.
背景
关于整脊疗法服务的使用，基于人群的信息较少。
方法
我们分析了兰德健康保险实验（HIE）的数据，这是一项基于社区的卫生服务使用研究。对所有完成研究的按服务收费患者的保险索赔表进行检查，以查找所有编码为接受整脊治疗师诊治的就诊记录。从这些表格中获取提供的服务和患者指定的症状。计算每个HIE站点的基于人群的使用率。首次就诊和复诊的使用率及服务分别进行计算。
结果
在研究期间，有5279人贡献了19021人年的暴露量；395名不同的人使用了7873次整脊疗法服务，就诊率为每100人年41次，使用率为7.5%。所有就诊中有42%是因背部疼痛。脊柱推拿占所有提供服务的61%。与未使用者相比，使用者倾向于为白人、中年、已婚且受过高中教育。整脊疗法服务的使用存在七倍的地理差异。
结论
整脊治疗师为美国人群提供了大量的医疗保健服务，并且整脊疗法服务的使用率和使用强度存在显著的地理差异。
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