Use and expenditure on complementary medicine in England: a population based survey
Use and expenditure on complementary medicine in England: a population based survey
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DOI：
10.1054/ctim.2000.0407
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发表时间：
2001-03-01
影响因子：
3.6
通讯作者：
Coleman, P
中科院分区：
文献类型：
--
作者：
Thomas, KJ;Nicholl, JP;Coleman, P
目的：许多人声称，补充药物的使用是一个重要的和不断增长的一部分，卫生保健行为。对美国和澳大利亚的从业者访问的估计表明，使用和支出水平很高。在英国，没有可靠的基于人群的从业者使用估计。方法：在1998年，以前试点邮寄问卷发送到一个地理分层，随机抽样的5010名成年人在英格兰。调查问卷的重点是从业者的联系，但也询问了购买非处方药的情况。要求提供更多关于社会人口特征、健康感知和最近NHS资源使用的信息。使用信息包括就诊原因、费用、保险和就诊地点。主要结果指标：终生使用和过去12个月使用针灸、脊椎按摩疗法、顺势疗法、催眠疗法、草药疗法、整骨疗法的人口估计数（按年龄组和性别分列）。估计两个额外的治疗（反射和芳香疗法），顺势疗法或草药购买的柜台。1998年开业医生年度自费就诊费用估计数。结果：达到60%的粗响应率（调整响应率59%）。应答者是有序的，比无应答者更可能是女性。使用样本框架的年龄/性别特征对可用回答（n = 2669）进行加权。根据这些调整后的数据，我们估计10.6%（95% CI 9.4至11.7）的英格兰成年人群在过去12个月内至少拜访过一位治疗师，提供了6种更成熟的治疗方法中的任何一种（13.6%使用了8种指定治疗方法中的任何一种，95% CI 12.3至14.9）。如果包括所有八种疗法和使用非处方药的自我护理，则过去12个月内使用的估计比例上升至28.3%（95% CI 26.6至30.0），终身使用的估计比例上升至46.6%（95% CI 44.6至48.5）。所有类型的使用在年龄较大的群体中都有所下降，并且女性比男性更常见（所有比较P <0.0 I）。1998年，估计有2 200万人次访问了六种既定疗法之一的从业人员。NHS提供了这些接触的估计10%。大多数非国民保健服务的访问是通过直接自付支出资助的。六种更成熟的治疗方法中任何一种的年度自付支出估计为4.5亿美元（95% CI 357至543）。结论：这项调查表明，1998年在英国大量使用的辅助治疗。研究结果表明，CAM正在为首次接触初级保健做出可衡量的贡献。然而，我们已经表明，90%的这一规定是私人购买。现在迫切需要进一步研究特定患者群体的不同CAM疗法的成本效益，以促进通过NHS的平等和适当的访问。(C)2001年哈考特出版社有限公司
Objectives: Many claims are made that complementary medicine use is a substantial and growing part of health-care behaviour. Estimates of practitioner visits in the USA and Australia indicate high levels of use and expenditure. No reliable population-based estimates of practitioner use are available for the UK. Methods: In 1998, a previously piloted postal questionnaire was sent to a geographically stratified, random sample of 5010 adults in England. The questionnaire focuses on practitioner contacts, but also asked about the purchase of over-the-counter remedies. Additional information was requested on socio-demographic characteristics, perceived health, and recent NHS resource use. Information on use included reason for encounter, expenditure, insurance, and location of visit. Main outcome measures: Population estimates (by age group and sex) of lifetime use and use in the past 12 months for acupuncture, chiropractic, homoeopathy, hypnotherapy, medical herbalism, osteopathy. Estimates for two additional therapies (reflexology and aromatherapy), and homoeopathic or herbal remedies purchased over-the-counter. Estimates of annual out-of-pocket expenditure on practitioner visits in 1998. Results: A crude response rate of 60% was achieved (adjusted response rate 59%). Responders were order and more likely to be female than non-responders. Usable responses (n = 2669) were weighted using the age/sex profile of the sample frame. From these adjusted data we estimate that 10.6% (95% CI 9.4 to 11.7) of the adult population of England had visited at least one therapist providing any one of the six more established therapies in the past 12 months (13.6% for use of any of the eight named therapies, 95% CI 12.3 to 14.9). If all eight therapies, and self-care using remedies purchased over the counter are included, the estimated proportion rises to 28.3% (95% CI 26.6 to 30.0) for use in the past 12 months, and 46.6% (95% CI 44.6 to 48.5) for lifetime use. All types of use declined in older age groups, and were more commonly reported by women than men (P < 0,0 I for all comparisons). An estimated 22 million visits were made to practitioners of one of the six established therapies in 1998. The NHS provided an estimated 10% of these contacts. The majority of non-NHS visits were financed through direct out-of-pocket expenditure. Annual out-of-pocket expenditure on any of the six more established therapies was estimated at 450 million (95% CI 357 to 543). Conclusion: This survey has demonstrated substantial use of practitioner-provided complementary therapies in England in 1998. The findings suggest that CAM is making a measurable contribution to first-contact primary care. However, we have shown that 90% of this provision is purchased privately. Further research into the cost-effectiveness of different CAM therapies for particular patient groups is now urgently needed to facilitate equal and appropriate access via the NHS. (C) 2001 Harcourt Publishers Ltd.