Do general practices which provide an acupuncture service have low referral rates and prescription costs? A pilot survey
Do general practices which provide an acupuncture service have low referral rates and prescription costs? A pilot survey
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DOI：
10.1136/aim.26.4.205
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发表时间：
2008-12-01
影响因子：
2.5
通讯作者：
Livingstone, Ruth
中科院分区：
文献类型：
--
作者：
Johnson, Gina;White, Adrian;Livingstone, Ruth
针灸从业者个人的研究表明，在初级保健中提供针灸可以减少转诊到二级保健的需要，并降低处方费用。了解这些调查结果是否能得到其他做法的数据的支持将是有益的。本研究的目的是测试的可行性调查国家数据的转介和prescribing.Methods的初级保健信托（PCT）被选中，并在每个信托的所有做法发送电子邮件询问是否有任何成员的初级保健团队提供针灸，如果是这样，每周有多少预约。然后从PCT中寻找关于骨科、物理治疗、疼痛和风湿病诊所转诊率的数据，包括提供针灸的诊所和整个PCT。同样，非甾体类（NSAID）和非阿片类镇痛药物的处方费用的数据，从处方定价Authority.Results的109个做法的调查，共14（13%）提供针灸服务在一定程度上。不同的多氯联苯治疗在提供方面存在很大差异。分析中包括了为每2000名登记患者每周至少提供一次预约的8个诊所。三种PCT和八种针灸实践的平均值（和SD）分别如下：转诊到不同诊所：骨科32.3（16.2）和27.4（10.87）;疼痛诊所1.6（1.3）和2.8（1.6）;物理治疗13.4（14.5）和29.5（10.0）;以及流变学4.7（2.3）和6.4（3.0）。非阿片类镇痛药的平均成本分别为1820磅（442）和2008磅（762）; NSAID的平均成本分别为4148磅（269）和4476磅（1366）。有没有减少诊所转诊或处方costs. Conclusions的趋势，我们已经进行了第一次调查，提供针灸在英国的一般做法的影响，使用NHS提供的数据，并发现了广泛的变化，在不同地区的服务的可用性。我们一直无法证明任何一致的差异，在处方或转诊率，可能是由于使用针灸在这些做法。数据的广泛变化意味着如果存在这种趋势，则需要进行非常大的调查来确定它。然而，我们发现PCT的数据呈现不准确和变化，这使得数字输入，从而使我们的结果不可靠。因此，由于获取数据的实际性和数据准确性问题，无法进行全国范围的调查。
Background Studies by individual acupuncture practitioners have given an indication that offering acupuncture in primary care may reduce the need for referral to secondary care and reduce the costs of prescriptions. It would be informative to find out whether these findings can be supported by data from other practices. The aim of this study was to test the feasibility of surveying national data on referrals and prescribing.Methods Three primary care trusts (PCTs) were selected, and all practices within each trust were sent an email asking whether any member of the primary care team offered acupuncture, and if so how many appointments per week. Data on rates of referral to orthopaedic, physiotherapy, pain and rheumatology clinics were then sought from the PCT, both for the practices offering acupuncture and for the PCT as a whole. Similarly, data on costs of prescriptions for non-steroidal (NSAID) and non-opioid analgesic drugs were obtained from the Prescription Pricing Authority.Results Out of the 109 practices surveyed, a total of 14 (13%) offered acupuncture services to some extent. There was wide variation in provision between the different PCTs. The eight practices which offered at least one appointment per week for every 2000 registered patients were included in the analysis. The mean values (and SDs) for the three PCTs and for the eight acupuncture practices, respectively, were as follows: for referral to various clinics: orthopaedic 32.3 (16.2) and 27.4 (10.87); pain clinic 1.6 (1.3) and 2.8 (1.6); physiotherapy 13.4 (14.5) and 29.5 (10.0); and rheumatology 4.7 (2.3) and 6.4 (3.0). The mean values for costs of non-opioid analgesics were 1820 pound (442) pound and 2008 pound (762); pound and for NSAIDs were 4148 pound (269) pound and 4476 pound (1366) pound, respectively. There were no trends towards a reduction of clinic referral or prescription costs.Conclusions We have conducted the first survey of the effects of provision of acupuncture in UK general practice, using data provided by the NHS, and uncovered a wide variation in the availability of the service in different areas. We have been unable to demonstrate any consistent differences in the prescribing or referral rates that could be due to the use of acupuncture in these practices. The wide variation in the data means that if such a trend exists, a very large survey would be needed to identify it. However, we discovered inaccuracies and variations in presentation of data by the PCTs which have made the numerical input, and hence our results, unreliable. Thus the practicalities of access to data and the problems with data accuracy would preclude a nationwide survey.