Zodet Marc W, Stevans Joel M
Center for Financing, Access, and Cost Trends, Agency for Healthcare Research and Quality, Rockville, MD, USA.
J Manipulative Physiol Ther. 2012 Oct;35(8):580-8. doi: 10.1016/j.jmpt.2012.10.001.
The purpose of this study was to produce prevalence estimates and identify determinants of variability in chiropractic use in the US adult population.
The Medical Expenditure Panel Survey was used to estimate prevalence for the adult population and subpopulations according to several sociodemographic, geographic, and health characteristics. Multivariable logistic regression model was used to explore the effects of the independent predictors on chiropractic use.
The 2008 chiropractic prevalence of use was estimated to be 5.2% (95% confidence interval, 4.7-5.6). The adjusted odds of using chiropractic services were approximately 46% less for Asians, 63% less for Hispanics, and 73% less for blacks compared with whites; 21% less for men than women; and 68% higher for those with arthritis compared with those without. Persons from high-income families have greater odds of using chiropractic services compared with those from middle-income (42%) and low-income (67%) families. There was a significant interaction between Census region and urban-rural location. The results showed the prevalence of chiropractic use to be highest in small metro areas in the Midwest (10.5%) and Northeast (10.4%) as well as micropolitan/noncore areas in the West (10.8%) and Midwest (10.1%).
This study validates previous findings showing the prevalence of use is higher for whites, women, and persons with higher family income or reported arthritis. The results of this study also indicate that chiropractic use varies across the urban-rural landscape depending on the region of the country, suggesting that the effect of geographic location may be more complex than previously reported.
本研究旨在得出美国成年人群中整脊疗法使用情况的患病率估计值,并确定其使用差异的决定因素。
利用医疗支出小组调查,根据社会人口统计学、地理和健康特征,对成年人群及亚人群的患病率进行估计。采用多变量逻辑回归模型探讨独立预测因素对整脊疗法使用情况的影响。
2008年整脊疗法的使用率估计为5.2%(95%置信区间,4.7 - 5.6)。与白人相比,亚洲人使用整脊疗法服务的校正比值比约低46%,西班牙裔低63%,黑人低73%;男性比女性低21%;患有关节炎的人比未患关节炎的人高68%。与来自中等收入(42%)和低收入(67%)家庭的人相比,高收入家庭的人使用整脊疗法服务的几率更高。人口普查区域与城乡位置之间存在显著交互作用。结果显示,整脊疗法的使用率在中西部(10.5%)和东北部(10.4%)的小型都市地区以及西部(10.8%)和中西部(10.1%)的微型都市/非核心地区最高。
本研究验证了先前的研究结果,即白人、女性、家庭收入较高或报告患有关节炎的人使用率较高。本研究结果还表明,整脊疗法的使用情况因国家地区不同而在城乡分布上存在差异,这表明地理位置的影响可能比先前报道的更为复杂。