Wearn A M, Greenfield S M
Department of General Practice, Medical School, Edgbaston, Birmingham.
J R Soc Med. 1998 Sep;91(9):465-70. doi: 10.1177/014107689809100904.
Complementary therapy (CT) has become increasingly popular with the general public and interest from the health professions has been rising. There has been no study focusing on the pattern of availability of CT within urban and inner-city general practice. We aimed to describe the prevalence and pattern of access to complementary therapy in this setting, identifying the characteristics of practices offering CT and the perceived barriers to service provision. We sent a postal questionnaire to all 254 general practices on the Birmingham Family Health Services Authority list. Practices were asked whether they offered any access to CTs, how services were organized and which therapies were available and to identify any barriers to provision. 175 practices (68.9%) responded. Half of the practices offered access to CT. Of these, half offered an in-house service, usually provided by the doctor (81.8%). Of GPs practising therapies themselves, 58% began in or after 1990. Seventeen separate therapies were offered, most commonly acupuncture, osteopathy, chiropractic, hypnotherapy and homoeopathy. Practices significantly more likely to offer access to CT were of larger list size and training or teaching practices. They were equally likely to be fundholders or non-fundholders. Practices offering an in-house service tended to be fundholding, training and of larger list size. Finance was perceived as the major barrier. In the area studied, many patients now have some access to CT within primary care, often within their own practice. In the main, therapies offered are the 'medically acceptable face' of complementary medicine.
补充疗法(CT)在普通大众中越来越受欢迎,医疗行业对此的兴趣也在不断上升。目前还没有研究关注城市及市中心全科医疗中补充疗法的可获得模式。我们旨在描述这种情况下补充疗法的普及程度和获取模式,确定提供补充疗法的医疗机构的特征以及服务提供过程中察觉到的障碍。我们向伯明翰家庭健康服务管理局名单上的所有254家全科医疗机构邮寄了问卷。问卷询问这些机构是否提供任何补充疗法、服务是如何组织的、提供哪些疗法以及确定提供服务的任何障碍。175家机构(68.9%)回复了问卷。一半的机构提供补充疗法。其中,一半提供内部服务,通常由医生提供(81.8%)。在自行实施疗法的全科医生中,58%是在1990年或之后开始的。共提供了17种不同的疗法,最常见的是针灸、整骨疗法、脊椎按摩疗法、催眠疗法和顺势疗法。更有可能提供补充疗法的机构名单规模更大,且是培训或教学机构。它们成为基金持有机构或非基金持有机构的可能性相同。提供内部服务的机构往往是基金持有机构、培训单位且名单规模更大。资金被视为主要障碍。在所研究的地区,现在许多患者在初级医疗中能够获得某种补充疗法,通常是在他们自己就诊的机构。总体而言,所提供的疗法是补充医学中“医学上可接受的方面”。