Chiropractic and CAM Utilization: A Descriptive Review

doi:10.1186/1746-1340-15-2

Table 2

Table of results for utilization papers.

Author	Ref	Design	N/Np	Main Results
Simpson	26	Mail survey	1509/784 (52%)	52% response rate. Referral rates varied depending on type of practitioner being referred to: 95% of respondents would refer to a PT, but only 14% would refer to a chiropractor. Respondents did not feel chiropractors should have primary contact status.
McCann	28	Analysis of Medical Expenditure Survey Data	25096	Chiropractic comprised 6% of all office-based health care visits; chiropractors accounted for 14% of all non-physician office-based expenditures.
Sharma	29	Prospective longitudinal non-randomized practice-based observational study	1414	Patients who self referred to DCs were likely to be older and have higher incomes than those who self referred to MDs; those who expected to self-pay more were more likely to self refer to the DC.
Jain	30	Mail survey	1680/601 (36%)	Response rate 35.8%; Variables that predicted disuse of CAM included male sex, good health, lack of physician support for CAM, and belief that CAM is not effective. For chiropractic, presence of perceived side effects was a major reason for disuse.
Pirotta	31	Mail survey	800/488 (64%)	Less acceptance for chiropractic compared to acupuncture, hypnosis and meditation. 75% felt chiropractic was sometimes harmful, but 29% would refer to a DC.
Astin	32	Review	25 surveys	Chiropractic had second highest rate of physician referral (40% behind massage (43%). 53% believed in the efficacy of chiropractic.
Goldszmidt	34			58% MD referral rate to chiropractors
Verhoef	35			83% MD referral rate to chiropractors
Perkin	36			34% MD referral rate to chiropractors
Andersson	37			50% MD referral rate to chiropractors
Wharton	38			51% MD referral rate to chiropractors
Marshall	39			2% MD referral rate to chiropractors
Hadley	40			27% MD referral rate to chiropractors
Reilly	41			20% MD referral rate to chiropractors
Berman	42			56% MD referral rate to chiropractors
Borkan	43			15% MD referral rate to chiropractors
Cherkin	44			57% MD referral rate to chiropractors
Goldstein	45			51% MD referral rate to chiropractors
Hawk	46	Mail survey	1896/563 (30%)	68% believe chiropractic is a therapeutic modality; 82% believe it is complete system.
Berman	47	Conference survey	180/295 (61%)	70–90% consider complementary medical procedures as legitimate.
Smith	48	Mail survey	1877/815 (43%)	Chiropractors offer a substantial amount of care to those in underserved populations.
Eisenberg	49	Telephone survey	1991: 1539 1997: 2055	CAM use grew from 33.8% to 42.1%, but chiropractic grew only from 10.1% to 11%. Mean number of visits fell from 12.6 to 8.9.
Eisenberg	50	Telephone survey	2055/831 (40%)	70% of patients saw a medical doctor before seeing a CAM provider; 15% saw a CAM provider before seeing an MD.60% did not disclose their CAM use to their MD.
Kessler	51	Telephone survey	2055/831 (40%)	30% of pre-baby boom group had used CAM; 50% of the boom group had used CAM; 70% of the post-baby boom group had used CAM.