The United States Chiropractic Workforce: An alternative or complement to primary care?
The United States Chiropractic Workforce: An alternative or complement to primary care?
复制标题
美国脊椎按摩疗法劳动力：初级保健的替代或补充？
DOI：
10.1186/2045-709x-20-35
复制
发表时间：
2012-11-21
影响因子：
1.9
通讯作者：
Weeks WB
中科院分区：
文献类型：
--
作者：
Davis MA;Mackenzie TA;Coulter ID;Whedon JM;Weeks WB
在美国（US）初级保健医生的短缺已经变得明显。其他的医疗保健提供者，如脊椎指压治疗师，可能仅仅因为他们位于初级保健资源较少的地区，就能帮助解决国家的一些初级保健需求。因此，本研究的目的是检查全国脊椎指压治疗人员的分布，并将其与初级保健医生的分布进行比较。我们使用具有全国代表性的数据，根据306个预先确定的医院转诊地区，估计每10万人均脊骨按摩师和初级保健医生的供应量。使用多变量泊松回归来检验人口特征对两种从业人员类型的供应的影响。根据这些数据，美国有74,623名脊医，全国各地的人均脊医供应量差异超过10倍。与初级保健医生相比，脊医在初级保健医生供应较多的地区执业（Pearson’s correlation 0.17， p值< 0.001），并且在执业地点方面似乎对市场条件（即受人口特征的影响更大）反应更迅速。这些发现表明，脊椎按摩师在初级保健医生供应较多的地区执业。因此，脊椎指压治疗师可能在初级保健中发挥更多的补充作用，而不是作为替代途径。
In the United States (US) a shortage of primary care physicians has become evident. Other health care providers such as chiropractors might help address some of the nation’s primary care needs simply by being located in areas of lesser primary care resources. Therefore, the purpose of this study was to examine the distribution of the chiropractic workforce across the country and compare it to that of primary care physicians. We used nationally representative data to estimate the per 100,000 capita supply of chiropractors and primary care physicians according to the 306 predefined Hospital Referral Regions. Multiple variable Poisson regression was used to examine the influence of population characteristics on the supply of both practitioner-types. According to these data, there are 74,623 US chiropractors and the per capita supply of chiropractors varies more than 10-fold across the nation. Chiropractors practice in areas with greater supply of primary care physicians (Pearson’s correlation 0.17, p-value < 0.001) and appear to be more responsive to market conditions (i.e. more heavily influenced by population characteristics) in regards to practice location than primary care physicians. These findings suggest that chiropractors practice in areas of greater primary care physician supply. Therefore chiropractors may be functioning in more complementary roles to primary care as opposed to an alternative point of access.