The effect of acupuncture utilization on healthcare utilization
The effect of acupuncture utilization on healthcare utilization
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DOI：
10.1097/mlr.0b013e3181589b7d
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发表时间：
2008-01-01
期刊：
影响因子：
3
通讯作者：
Brown, Theodore
中科院分区：
文献类型：
--
作者：
Bonafede, Machaon;Dick, Andrew;Brown, Theodore
目的：为了确定针灸是否是各种医疗服务的补充或替代。数据来源：本研究使用了2002年一家中型大都市保险公司的管理式医疗索赔数据。还纳入了2000年美国人口普查的邮政编码级别数据。原始数据集包含的医疗和药物索赔数据为每一个合格的针灸用户（n = 1688）和每第18个合格的nonacupuncture用户（n = 16,282）所涵盖的data provider.Study设计：在这个横断面研究中使用的排除限制的联立方程模型。针灸利用的影响进行了独立评估，对每一个传统的服务的利益，控制众多的临床和人口统计学特征。双变量概率模型估计使用距离最近的acupuncturist作为排除restriction.Results：针灸是一个有统计学意义（P < 0.05）的替代初级保健，所有门诊服务，病理服务，所有手术，胃肠药物。针灸似乎补充了许多疗法，特别是整脊疗法和物理疗法，但是，针灸没有统计学上显着的补充后，控制不可观察的特点，影响使用针灸和/或传统medicine.Conclusions的任何疗法：针灸是一种经济的替代品，一些医疗服务和药品，保险公司，医疗从业者和政策制定者的一些重要性的发现。针灸对其他医疗服务的影响需要更充分地探讨，重点是这种替代如何影响患者健康。
Objective: To determine whether acupuncture is a complement to or substitute for various medical services.Data Source: This study used managed care claims data from a midsize metropolitan insurance company from 2002. Zip code level data from the 2000 US Census was also incorporated. The original dataset contained medical and drug claims data for every eligible acupuncture user (n = 1688) and every 18th eligible nonacupuncture user (n = 16,282) covered by the data provider.Study Design: Simultaneous equations models with an exclusion restriction were used in this cross-sectional study. The influence of acupuncture utilization was assessed independently on each conventional service of interest, controlling for numerous clinical and demographic characteristics. Bivariate probit models were estimated using distance to the nearest acupuncturist as the exclusion restriction.Results: Acupuncture was a statistically significant (P < 0.05) substitute for primary care, all outpatient services, pathology services, all surgery, and gastrointestinal medications. Acupuncture seemed to complement numerous therapies, particularly chiropractic and physical therapy; however, acupuncture did not statistically significantly complement any therapies after controlling for unobservable characteristics that influence the use of acupuncture and/or conventional medicine.Conclusions: Acupuncture is an economic substitute for some medical services and pharmaceuticals, a finding of some importance to insurers, healthcare practitioners, and policy makers. The fact that acupuncture has an effect on other medical services needs to be explored more fully with an emphasis on how this substitution impacts patient health.