Regional Supply of Chiropractic Care and Visits to Primary Care Physicians for Back and Neck Pain.
Regional Supply of Chiropractic Care and Visits to Primary Care Physicians for Back and Neck Pain.
复制标题
DOI：
10.3122/jabfm.2015.04.150005
复制
发表时间：
2015-07
期刊：
影响因子：
--
通讯作者：
Bynum JP
中科院分区：
文献类型：
--
作者：
Davis MA;Yakusheva O;Gottlieb DJ;Bynum JP
脊椎指压治疗的可用性是否会影响初级保健医生（PCP）服务的使用尚不清楚。我们对2010年至2011年参加Medicare的1770万老年人进行了横断面研究。我们使用斯皮尔曼相关性检验了脊椎指压治疗的区域供应与PCP服务之间的关系。广义线性模型被用来检查脊椎按摩治疗的区域供应和每年访问PCP背部和/或颈部疼痛的数量之间的关联。我们发现脊椎按摩治疗的区域供应与PCP服务之间存在正相关（rs = 0.52; P <.001）。脊椎按摩治疗的供应与每年因背部和/或颈部疼痛而到PCP就诊的人数之间存在明显的负相关。脊椎指压治疗供应量最高的五分之一人群因背部和/或颈部疼痛而就诊的PCP数量比最低的五分之一人群低8%（率比为0.92; 95%置信区间为0.91-0.92）。我们估计，脊椎指压治疗与全国减少37万人次的PCP就诊有关，费用为8350万美元。在某些地区，脊椎指压治疗的更多可用性可能会抵消老年人背部和/或颈部疼痛的PCP服务。（J Am Board Fam Med 2015;28：000-000.）
Whether availability of chiropractic care affects use of primary care physician (PCP) services is unknown. We performed a cross-sectional study of 17.7 million older adults who were enrolled in Medicare from 2010 to 2011. We examined the relationship between regional supply of chiropractic care and PCP services using Spearman correlation. Generalized linear models were used to examine the association between regional supply of chiropractic care and number of annual visits to PCPs for back and/or neck pain. We found a positive association between regional supply of chiropractic care and PCP services (rs = 0.52; P <.001). An inverse association between supply of chiropractic care and the number of annual visits to PCPs for back and/or neck pain was apparent. The number of PCP visits for back and/or neck pain was 8% lower (rate ratio, 0.92; 95% confidence interval, 0.91–0.92) in the quintile with the highest supply of chiropractic care compared to the lowest quintile. We estimate chiropractic care is associated with a reduction of 0.37 million visits to PCPs nationally, at a cost of $83.5 million. Greater availability of chiropractic care in some areas may be offsetting PCP services for back and/or neck pain among older adults. (J Am Board Fam Med 2015;28:000–000.)