Kelly Government Solutions, Rockville, MD, USA.
National Center for Complementary and Integrative Health (NCCIH), National Institutes of Health, Bethesda, MD, USA.
J Integr Complement Med. 2022 Aug;28(8):641-650. doi: 10.1089/jicm.2021.0331. Epub 2022 May 13.
The Institute of Medicine has described the need for comparing models of care delivery involving complementary health approaches and conventional medical practitioners. As a step toward addressing this need, we used a nationally representative 11-year sample of office-based visits to physicians from the National Ambulatory Medical Care Survey (NAMCS), to examine a comprehensive list of factors believed to be associated with visits where complementary health approaches were recommended or provided. NAMCS is a national health care survey designed to collect data on the provision and use of ambulatory medical care services provided by office-based physicians in the United States. Patient medical records were abstracted from a random sample of office-based physician visits. We examined several visit characteristics, including patient demographics, physician specialty, documented health conditions, and reasons for health visit. We ran chi-square analyses to test bivariate associations between visit factors and whether complementary health approaches were recommended or provided to guide development of logistic regression models. Of the 550,114 office visits abstracted, 4.43% contained a report that complementary health approaches were ordered, supplied, administered, or continued. Among complementary health visits, 87% of patient charts mentioned nonvitamin nonmineral dietary supplements. The prevalence of complementary health visits significantly increased from 2% in 2005 to almost 8% in 2015. Returning patient status, survey year, physician specialty and degree, menopause, cardiovascular, and musculoskeletal diagnoses were significantly associated with complementary health visits, as was seeking preventative care or care for a chronic problem. We present an overview of the first study of office-based physician visits where complementary health approaches were recommended or ordered to their patients. These data confirm the growing popularity of complementary health approaches in the United States, provide a baseline for further studies, and inform subsequent investigations of integrative health care.
美国医学研究所描述了需要比较涉及补充医学方法和传统医学从业者的医疗保健模式。为了满足这一需求，我们使用了全国代表性的 11 年全国门诊医生调查（NAMCS）的办公室就诊样本，以检查被认为与推荐或提供补充健康方法相关的综合因素列表。NAMCS 是一项全国性的医疗保健调查，旨在收集美国办公室医生提供和使用的门诊医疗服务的数据。从办公室医生就诊的随机样本中提取了患者的医疗记录。我们检查了几种就诊特征，包括患者人口统计学特征、医生专业、记录的健康状况和就诊原因。我们进行了卡方分析，以测试就诊因素与补充健康方法是否被推荐或提供之间的双变量关联，以指导逻辑回归模型的开发。在提取的 550,114 次办公室就诊中，有 4.43%的就诊记录报告补充健康方法被开处方、供应、管理或继续。在补充健康就诊中，87%的患者记录提到了非维生素非矿物质膳食补充剂。从 2005 年的 2%到 2015 年的近 8%，补充健康就诊的比例显著增加。复诊患者身份、调查年份、医生专业和学位、绝经、心血管和肌肉骨骼诊断与补充健康就诊显著相关，寻求预防保健或慢性问题的治疗也是如此。我们概述了第一项关于办公室医生就诊的研究，其中补充健康方法被推荐或开给患者。这些数据证实了补充健康方法在美国的普及程度不断提高，为进一步研究提供了基础，并为随后的综合医疗保健调查提供了信息。
