Shekelle P G, Brook R H
Department of Medicine, University of California Los Angeles 90024.
Am J Public Health. 1991 Apr;81(4):439-42. doi: 10.2105/ajph.81.4.439.
Little population-based information is available on the use of chiropractic services.
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.
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.
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.
关于整脊疗法服务的使用，基于人群的信息较少。
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。
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。
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。
