Cooper Forrest, Marx Benjamin L, Lee Tamsin L, Espesete Deborah
Department of Research, Oregon College of Oriental Medicine , Portland, OR.
J Altern Complement Med. 2017 Mar;23(3):222-226. doi: 10.1089/acm.2016.0419. Epub 2017 Feb 7.
The use of acupuncture in the United States has consistently grown over the last two decades, and the National Center for Complementary and Integrative Health has recently called for greater understanding of "real life outcomes and use" by complementary and alternative medicine users. This study assesses the demographics and utilization patterns of "super-users" treated at the Oregon College of Oriental Medicine intern clinic.
This was a retrospective chart review at the Oregon College of Oriental Medicine (OCOM) intern clinic, a large acupuncture and oriental medicine (AOM) school in Portland, Oregon. Participants were patients who were treated 100+ times at the OCOM between August 6, 2002, and 2012. The outcome measures were demographic and treatment characteristics, including sex, age, chief complaint, income, medication use, and visit patterns.
The super-user cohort comprised approximately 1.5% of the total annual patient population and 8% of total visits at the OCOM in any given year, with an average treatment duration of 4 years from visit 1 to visit 100, and a visit frequency of 32 visits per year. Similar to other studies, the super-user cohort consisted predominantly of older, female patients seeking treatment primarily for pain (57.3%). Prescription medication use (45.2%) was also similar to other acupuncture cohorts. In contrast to typical AOM patients, OCOM super-users were older, with 64% being age ≥50 years when initiating treatment, and a majority reported low-income status (92%).
Super-users represent a small yet real subset of AOM patients. They tend to be older, report lower income, and exhibit greater visit frequency than more typical AOM users. The factors motivating AOM super-user behavior may be different from those in other medical domains, notably emergency medicine, and likely include long-term management of chronic pain and other chronic conditions. Future studies into the long-term health outcomes of AOM super-users, as well as the economic impact on other health services, are warranted.
在过去二十年中，针灸在美国的使用量持续增长，美国国立补充与综合健康中心最近呼吁要更好地了解补充和替代医学使用者的“实际疗效和使用情况”。本研究评估了在俄勒冈东方医学院实习诊所接受治疗的“超级使用者”的人口统计学特征和使用模式。
这是一项对俄勒冈东方医学院（OCOM）实习诊所的回顾性病历审查，该诊所位于俄勒冈州波特兰市，是一所大型针灸与东方医学（AOM）学校。研究对象为2002年8月6日至2012年期间在OCOM接受过100次以上治疗的患者。观察指标为人口统计学和治疗特征，包括性别、年龄、主诉、收入、用药情况和就诊模式。
超级使用者群体约占OCOM每年患者总数的1.5%，以及任何给定年份总就诊次数的8%，从首次就诊到第100次就诊的平均治疗时长为4年，每年就诊频率为32次。与其他研究类似，超级使用者群体主要由年龄较大的女性患者组成，她们主要因疼痛寻求治疗（57.3%）。处方药使用情况（45.2%）也与其他针灸患者群体相似。与典型的AOM患者相比，OCOM超级使用者年龄更大，开始治疗时64%的患者年龄≥50岁，且大多数报告为低收入状态（92%）。
超级使用者代表了AOM患者中一个虽小但真实存在的子集。他们往往年龄较大，收入较低，且就诊频率高于更典型的AOM使用者。促使AOM超级使用者行为的因素可能与其他医学领域（尤其是急诊医学）不同，可能包括慢性疼痛和其他慢性病的长期管理。有必要对AOM超级使用者的长期健康结局以及对其他医疗服务的经济影响进行进一步研究。
