Marc W Zodet1, Joel M Stevans. 1. Center for Financing, Access, and Cost Trends, Agency for Healthcare Research and Quality, Rockville, MD, USA.
Abstract
OBJECTIVE: The purpose of this study was to produce prevalence estimates and identify determinants of variability in chiropractic use in the US adult population. METHODS: The Medical Expenditure Panel Survey was used to estimate prevalence for the adult population and subpopulations according to several sociodemographic, geographic, and health characteristics. Multivariable logistic regression model was used to explore the effects of the independent predictors on chiropractic use. RESULTS: The 2008 chiropractic prevalence of use was estimated to be 5.2% (95% confidence interval, 4.7-5.6). The adjusted odds of using chiropractic services were approximately 46% less for Asians, 63% less for Hispanics, and 73% less for blacks compared with whites; 21% less for men than women; and 68% higher for those with arthritis compared with those without. Persons from high-income families have greater odds of using chiropractic services compared with those from middle-income (42%) and low-income (67%) families. There was a significant interaction between Census region and urban-rural location. The results showed the prevalence of chiropractic use to be highest in small metro areas in the Midwest (10.5%) and Northeast (10.4%) as well as micropolitan/noncore areas in the West (10.8%) and Midwest (10.1%). CONCLUSIONS: This study validates previous findings showing the prevalence of use is higher for whites, women, and persons with higher family income or reported arthritis. The results of this study also indicate that chiropractic use varies across the urban-rural landscape depending on the region of the country, suggesting that the effect of geographic location may be more complex than previously reported.
OBJECTIVE: The purpose of this study was to produce prevalence estimates and identify determinants of variability in chiropractic use in the US adult population. METHODS: The Medical Expenditure Panel Survey was used to estimate prevalence for the adult population and subpopulations according to several sociodemographic, geographic, and health characteristics. Multivariable logistic regression model was used to explore the effects of the independent predictors on chiropractic use. RESULTS: The 2008 chiropractic prevalence of use was estimated to be 5.2% (95% confidence interval, 4.7-5.6). The adjusted odds of using chiropractic services were approximately 46% less for Asians, 63% less for Hispanics, and 73% less for blacks compared with whites; 21% less for men than women; and 68% higher for those with arthritis compared with those without. Persons from high-income families have greater odds of using chiropractic services compared with those from middle-income (42%) and low-income (67%) families. There was a significant interaction between Census region and urban-rural location. The results showed the prevalence of chiropractic use to be highest in small metro areas in the Midwest (10.5%) and Northeast (10.4%) as well as micropolitan/noncore areas in the West (10.8%) and Midwest (10.1%). CONCLUSIONS: This study validates previous findings showing the prevalence of use is higher for whites, women, and persons with higher family income or reported arthritis. The results of this study also indicate that chiropractic use varies across the urban-rural landscape depending on the region of the country, suggesting that the effect of geographic location may be more complex than previously reported.
Authors: Peter J H Beliveau; Jessica J Wong; Deborah A Sutton; Nir Ben Simon; André E Bussières; Silvano A Mior; Simon D French Journal: Chiropr Man Therap Date: 2017-11-22