Quality assurance in chiropractic practice: a comparison of two study methods.

OBJECTIVES

A comparison was made of two methods of data collection used in a quality-assurance study to determine whether the study samples were comparable and self-reported satisfaction similarly. We also investigated whether patients who dropped out of treatment early were more dissatisfied than those who remained for more treatments.

STUDY DESIGN

A comparison was made of data collected through self-administered, structured questionnaires in the two studies. Participants were invited consecutively by chiropractors in study 1; chiropractic patients, selected randomly from a reimbursement register, received a postal questionnaire in study 2.

PARTICIPANTS

Study 1 aimed for a maximum of 20 patients for each of 31 chiropractors included under a reimbursement scheme in the county of Stockholm, Sweden. Six hundred and sixteen patients entered the study, and 83% participated in a survey conducted at their third visit. Three hundred patients were invited to respond to the postal questionnaire at least 1 month after they received chiropractic care; the response rate was 77%.

MAIN OUTCOME MEASURES

Sociodemographic factors, area of complaint, sick-leave, perceived improvement, unpleasant side-effects and overall satisfaction with care.

RESULTS

There were no differences noted between the two study groups, and patients who received fewer than three treatments were no less satisfied than those who received more. Additional analyses indicate that factors other than dissatisfaction influence whether patients remain in therapy for fewer than three visits.

CONCLUSION

Quality-assurance studies conducted in the chiropractor's practice, using consecutive sampling and anonymous questionnaires, seem to give results that are similar to the more complex and costly method of obtaining randomly selected study subjects from a central source and collecting the information through anonymous postal surveys.