Olotu Busuyi S, Brown Carolyn M, Barner Jamie C, Lawson Kenneth A
1Division of Health Outcomes and Pharmacy Practice, College of Pharmacy, The University of Texas at Austin, Austin, TX, USA.
Am J Hosp Palliat Care. 2014 Jun;31(4):385-91. doi: 10.1177/1049909113489873. Epub 2013 May 20.
There is limited research about the provision of complementary and alternative (CAM) in US hospices. The purpose of this study was to assess the factors that influence hospices' likelihood of providing CAM therapies. Mail surveys were sent to 369 hospices in Texas; 61 were returned undelivered, yielding a total usable response rate of 35.7% (n = 110) after an initial and one follow-up mail out. Binary logistic regression was used to assess whether the likelihood of offering CAM is related to hospice's age, geographic location, agency type, profit orientation, Medicare certification, and number of patients served annually. Results showed that profit orientation and the number of patients served by hospices were significantly related to the probability that hospices will offer CAM. Specifically, the odds of offering CAM in not-for-profit hospices were approximately 4 times higher than that in for-profit hospices (odds ratio [OR] = 3.77, P = .022, 95% confidence interval [CI] = 1.2, 11.8). In addition, for every 100 patients served by the hospices, the odds of offering CAM increases by 13% (OR = 1.13, P = .015, 95% CI = 1.02, 1.25). In conclusion, CAM offering by hospices is related to hospices' profit orientation status and number of patients served but is not related to other measured characteristics of hospices.
关于美国临终关怀机构提供补充和替代医学（CAM）的研究有限。本研究的目的是评估影响临终关怀机构提供CAM疗法可能性的因素。向德克萨斯州的369家临终关怀机构发送了邮件调查问卷；61份未送达，在首次和一次跟进邮件发送后，总有效回复率为35.7%（n = 110）。采用二元逻辑回归分析来评估提供CAM的可能性是否与临终关怀机构的年龄、地理位置、机构类型、盈利导向、医疗保险认证以及每年服务的患者数量有关。结果表明，盈利导向和临终关怀机构服务的患者数量与临终关怀机构提供CAM的可能性显著相关。具体而言，非营利性临终关怀机构提供CAM的几率比营利性临终关怀机构高出约4倍（优势比[OR] = 3.77，P = .022，95%置信区间[CI] = 1.2，11.8）。此外，临终关怀机构每服务100名患者，提供CAM的几率就增加13%（OR = 1.13，P = .015，95% CI = 1.02，1.25）。总之，临终关怀机构提供CAM与临终关怀机构的盈利导向状况和服务的患者数量有关，但与临终关怀机构的其他测量特征无关。
