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Back Pain | Cost Effectiveness | Patient Satisfaction | Utilization | Government Recommendations | Safety

UTILIZATION OF CHIROPRACTIC

Over three million Canadians sought chiropractic care at least once in 1996, translating to about 30 million visits made to chiropractors. These utilization figures are increasing moderately from year to year, and studies consistently show chiropractic utilization being between 8 to 15 percent of the general population annually.

Approximately $500 million dollars were spent on chiropractic services in 1995. The use of non-traditional, or "unconventional" health care has risen dramatically over the last several years, as society is becoming more aware of alternative approaches and making more informed choices on matters of health.

For the purposes of this section the terms "alternative" and "unconventional" are to be interpreted as NOT the traditional medical approach. "Alternative" or "unconventional" SHOULD NOT be interpreted as necessarily lacking scientific basis.

Eisenberg, D.M., Kessler, R.C., Foster, C., Norlock, F.E., Calkins, D.R., Delbanco, T.L., (1993) "Unconventional Medicine in the United States: Prevalence, Costs, and Patterns of Use", New England Journal of Medicine, Vol. 328, pp. 246-252.

This recent groundbreaking survey found that the use of "unconventional medicine" has an enormous presence in the United States health care system. The estimated number of visits made in 1990 to providers of unconventional therapy (425 million) was greater than the number of visits to all primary care medical doctors (388 million). Approximately one in nine respondents made visits to an unconventional provider, and the annual utilization rate for chiropractors was found to be approximately 7 percent of the population.

Verhoef, M. J., Russell, M.L., Love, E.J. (1994) "Alternative Medical Use in Rural Alberta", Canadian Journal of Public Health, Vol. 85(5), pp. 308-309.

Results indicated that among youths and adults in Alberta visits to a chiropractor were more common than visits to a specialist. The prevalence of utilization of chiropractic services was found to be nearly three times higher than that in 1990. This study found that over one in four rural Albertans made a visit to a chiropractor’s office in a six-month period.

National Population Health Survey Overview (1994-1995) Catalogue 82-567, Statistics Canada, Health Statistics Division.

Described as "a new longitudinal survey on the health of Canadians" representing a "milestone for Statistics Canada", this national survey found that in 1994, 15% of adults – 3.3 million people – reported using some form of alternative medicine in the past year. The most common alternative health care was chiropractic services. Fully 11% of the population had consulted a chiropractor in the previous year.

MacLennan, A.H., Wilson, D.H., Taylor, A.W. (1996) "Prevalence and Cost of Alternative Medicine in Australia", The Lancet, Vol. 347, pp. 569-573.

This study is the largest survey in the world literature on the utilization of "alternative" providers. The survey found that on an annual basis, 20 percent of the south Australian population visited alternative medicine practitioners. By far the most common health care providers visited were chiropractors, by 15 percent of the population.

Millar, W. (1997) "Use of Alternative Health Care Practitioners by Canadians", Canadian Journal of Public Health, Vol. 88(3), pp. 154-158.

This study is an analysis of the data derived from the National Population Health Survey referred to in this section. Data from a total of 17,626 respondents were utilized in the analysis, the largest study of this type ever undertaken in Canada. Consultation with an alternative health care provider or with a chiropractor was deemed to be an indicator of the use of alternative health care. Because so many Canadian use chiropractor services, the investigator had to use a separate category of alternative health care practitioner that excluded chiropractors and one category just for chiropractors. The results indicated that an estimated 15% of Canadians aged 15 and over used an alternative practitioner during 1993-1994, of which 11% specifically consulted a chiropractor. The range of the annual consultation of chiropractors in this time period was found to as high as 17% in the Prairie Provinces and British Columbia, 10% in Ontario, 8% in Quebec and as low as 3% in the Atlantic Provinces. It was concluded that in general, the use of alternative practitioners other than chiropractors was low. This study is based on data now several years old, and current annual utilization rates for chiropractic services are higher.

CTV/Angus Reid Group Poll. Use of Alternative Medicines and Practices, September, 1997.

This report contains the results of an August, 1997, Canada-wide poll of a representative cross-section of 1200 Canadian adults aged 18 years and older. The survey found that over 42% of Canadians use alternative medicine and practices and of these 59% (which represents 25% of all Canadians) mention using chiropractic. It should be noted that these estimates are conservative because a great number of Canadians do not believe chiropractic is "alternative" and therefor the percentage of Canadians that have consulted chiropractors is higher than 25%.

One in five (19%) respondents reported having started using alternative medicines and practices within the past five years, signifying a growing trend. The poll found that seven in ten (70%) Canadians feel that provincial health care plans should cover the costs of alternative medicines and practices, and, further, two-thirds (66%) feel that the government should be advocating the use of alternative medicines and practices in order to potentially reduce the cost to the health care system, Of the 42% who use alternative medicines and practices, fully 80% feel that these treatments and practices are either "very" (32%) or "somewhat" (48%) important to their own health, and fully 90% are either "very" (48%) or "somewhat" (42%) satisfied with the alternative medicines or practices they have used.