Faculty of Nursing Midwifery and Health, University of Technology Sydney, Sydney, New South Wales, Australia.
BMC Complement Altern Med. 2011 Oct 7;11:85. doi: 10.1186/1472-6882-11-85.
Evidence indicates that people who reside in non-urban areas have a higher use of complementary and alternative medicine (CAM) than people who reside in urban areas. However, there is sparse research on the reasons for such differences. This paper investigates the reasons for geographical differences in CAM use by comparing CAM users from four geographical areas (major cities, inner regional, outer region, rural/remote) across a range of health status, healthcare satisfaction, neighbourhood and community factors.
A cross-sectional survey of 1,427 participants from the Australian Longitudinal Study on Women's Health (ALSWH) conducted in 2009.
The average total cost of consultations with CAM practitioners was $416 per annum and was highest for women in the major cities, declining with increasing distance from capital cities/remoteness (p < 0.001). The average total cost of self-prescribed CAM was $349 per annum, but this did not significantly differ across geographical areas. The increased use of CAM in rural and remote areas appears to be influenced by poorer access to conventional medical care (p < 0.05) and a greater sense of community (p < 0.05) amongst these rural and remote residents. In contrast to the findings of previous research this study found that health status was not associated with the differences in CAM use between urban and non-urban areas.
It appears that a number of factors influence the different levels of CAM use across the urban/non-urban divide. Further research is needed to help tease out and understand these factors. Such research will help support health care policy and practice with regards to this topic.
有证据表明,居住在非城市地区的人比居住在城市地区的人更倾向于使用补充和替代医学(CAM)。然而,关于这种差异的原因的研究很少。本文通过比较来自四个地理区域(主要城市、内区域、外区域、农村/偏远地区)的 CAM 用户在一系列健康状况、医疗保健满意度、邻里和社区因素方面,研究了 CAM 使用的地理差异的原因。
对 2009 年澳大利亚妇女健康纵向研究(ALSWH)中的 1427 名参与者进行了横断面调查。
CAM 从业者咨询的平均总费用为每年 416 美元,主要城市的女性最高,随着与首府城市/偏远地区的距离增加而降低(p <0.001)。自我开处方的 CAM 的平均总成本为每年 349 美元,但在地理区域之间没有显著差异。农村和偏远地区 CAM 使用的增加似乎受到常规医疗保健获取不足(p <0.05)和这些农村和偏远地区居民更大的社区感(p <0.05)的影响。与之前的研究结果相反,本研究发现健康状况与城市和非城市地区之间 CAM 使用的差异无关。
似乎有许多因素影响着城市/非城市地区之间 CAM 使用水平的差异。需要进一步研究以帮助梳理和理解这些因素。此类研究将有助于支持有关这一主题的医疗保健政策和实践。