互联网调查显示,日本私人诊所提供补充和替代医学服务:一项横断面研究。

Internet survey on the provision of complementary and alternative medicine in Japanese private clinics: a cross-sectional study.

机构信息

Department of Medical Oncology, Kanazawa Medical University, Ishikawa 920-0293, Japan.

Department of Health Policy and Technology Assessment, National Institute of Public Health, Saitama 351-0197, Japan.

出版信息

J Integr Med. 2019 Jan;17(1):8-13. doi: 10.1016/j.joim.2018.11.003. Epub 2018 Nov 17.

Abstract

OBJECTIVE

Although the use of complementary and alternative medicine (CAM) by the general population has been surveyed previously, the provision of CAM by Japanese physicians in private clinics has not been studied. Universal health insurance system was established in Japan in 1961, and most CAMs are not on the drug tariff. We aimed to clarify the current status of CAM provided by physicians at private clinics in Japan.

METHODS

We conducted an internet survey on 400 directors/physicians of private clinics nationwide on the provision of CAM from February 6 to February 10, 2017. Survey items included attributes of subjects, presence/absence of sections or facilities for provision of CAM, proportions of health insurance coverage for medical practices, and source of information. Private clinic was defined as a clinic run by one physician, with less than 20 beds.

RESULTS

Commonly provided CAMs were Kampo (traditional Japanese herbal) medicines (34.8%) and supplements/health foods (19.3%). CAMs on the drug tariff were provided in 46.5% of cases at the clinics, but only 16.5% of cases were provided CAMs which were not on the drug tariff, at different neighboring facilities. Among different specialties, Kampo medicines were prescribed at obstetrics/gynecology (54.0%), orthopedics (44.4%), and dermatology (43.0%). Clinics not providing any CAM accounted for 53.5%. With regard to health insurance coverage, 96.8% of the clinics provided only or mainly health services on the universal national health insurance tariff (29.8% and 67.0%, respectively).

CONCLUSION

Kampo medicines represent the most commonly used CAM in private clinics in Japan, and universal national health insurance coverage is considered to be the reason for the high rate of their use.

摘要

目的

尽管之前已经调查过普通人群对补充和替代医学(CAM)的使用情况,但日本私人诊所医生提供 CAM 的情况尚未研究。日本于 1961 年建立了全民健康保险制度,大多数 CAM 不在药品目录中。我们旨在阐明日本私人诊所医生提供 CAM 的现状。

方法

我们于 2017 年 2 月 6 日至 2 月 10 日对全国 400 名私人诊所主任/医生进行了一项关于 CAM 提供情况的互联网调查。调查项目包括主题属性、是否有提供 CAM 的科室/设施、医疗保险覆盖医疗实践的比例以及信息来源。私人诊所定义为由一名医生经营的、床位少于 20 张的诊所。

结果

常用的 CAM 包括汉方药(传统日本草药)(34.8%)和补充剂/保健品(19.3%)。诊所提供的药品目录中包含的 CAM 占 46.5%,但仅在 16.5%的情况下,在不同的相邻设施中提供药品目录外的 CAM。在不同的专业中,汉方药在妇产科(54.0%)、骨科(44.4%)和皮肤科(43.0%)中被开出处方。不提供任何 CAM 的诊所占 53.5%。在医疗保险覆盖方面,96.8%的诊所仅或主要提供全民健康保险目录下的健康服务(分别为 29.8%和 67.0%)。

结论

汉方药是日本私人诊所中最常用的 CAM,全民健康保险的覆盖范围被认为是其高使用率的原因。

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