Assuntos
Papel do Médico , Atenção Primária à Saúde/organização & administração , Administração em Saúde Pública , Saúde Pública , Humanos , Inflação/tendências , Itália , Liderança , Programas Nacionais de Saúde/economia , Programas Nacionais de Saúde/tendências , Atenção Primária à Saúde/economia , Atenção Primária à Saúde/tendências , Competência Profissional , Saúde Pública/economia , Saúde Pública/normas , Saúde Pública/tendências , Administração em Saúde Pública/economia , Administração em Saúde Pública/normas , Administração em Saúde Pública/tendênciasRESUMO
OBJECTIVE: To investigate national utilization and expenditures on chiropractic care between 1997 and 2006. DATA SOURCE: The nationally representative Medical Expenditure Panel Survey (MEPS). STUDY DESIGN: We performed descriptive analyses and generated national estimates from data obtained from U.S. adult (>or=18 years) MEPS respondents who reported having visited a chiropractor (annual sample size between 789 and 1,082). For each year, we examined the estimated total national expenditure, the total number of U.S. adults who received chiropractic care, the total number of ambulatory visits to U.S. chiropractors, and the inflation-adjusted charges and expenditures per U.S. adult chiropractic patient. PRINCIPAL FINDINGS: The total number of U.S. adults who visited a chiropractor increased 57 percent from 7.7 million in 2000 to 12.1 million in 2003. From 1997 to 2006, the inflation-adjusted national expenditures on chiropractic care increased 56 percent from U.S.$3.8 billion to U.S.$5.9 billion. Inflation-adjusted total mean expenditures per patient and expenditures per office visit remained unchanged. CONCLUSION: The large increase in U.S. adult expenditures on chiropractic care between 1997 and 2006 was due to a 57 percent increase in the total number of U.S. adult chiropractic patients that occurred from 2000 to 2003. From 2003 to 2006, the total number of U.S. adult chiropractic patients has remained stable.
Assuntos
Quiroprática/estatística & dados numéricos , Gastos em Saúde/tendências , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Adulto , Assistência Ambulatorial/estatística & dados numéricos , Honorários Médicos/tendências , Feminino , Pesquisas sobre Atenção à Saúde , Humanos , Inflação/tendências , Seguro Saúde/estatística & dados numéricos , Estudos Longitudinais , Masculino , Marketing de Serviços de Saúde , Pessoa de Meia-Idade , Visita a Consultório Médico/estatística & dados numéricos , Inquéritos e Questionários , Estados Unidos , Recursos HumanosRESUMO
France, Germany, Sweden, and the United Kingdom each use different types of policies for controlling prescription drug spending. Until recent years, these policies have relied heavily on regulating prices charged by drug manufacturers, with different systems providing varying degrees of pricing freedom. While these policies appear to have brought some degree of price restraint, they have not prevented continued growth in prescription drug spending. As a result, each country is supplementing its policies with measures aimed at physicians and consumers and targeted at reducing a perceived over-utilization of pharmaceutical products.