Assessing the change in prevalence and characteristics of canadians utilizing chiropractic services across two time periods 2001-2010 and 2015-2018: a population-based repeated cross-sectional study.
Humans
Cross-Sectional Studies
Canada
/ epidemiology
Male
Middle Aged
Female
Adult
Prevalence
Adolescent
Aged
Young Adult
Child
Chiropractic
/ statistics & numerical data
Musculoskeletal Diseases
/ epidemiology
Manipulation, Chiropractic
/ statistics & numerical data
Patient Acceptance of Health Care
/ statistics & numerical data
North American People
Chiropractic
Musculoskeletal disorders
Population-based
Prevalence
Utilization
Journal
Chiropractic & manual therapies
ISSN: 2045-709X
Titre abrégé: Chiropr Man Therap
Pays: England
ID NLM: 101551481
Informations de publication
Date de publication:
30 Oct 2024
30 Oct 2024
Historique:
received:
15
08
2024
accepted:
15
10
2024
medline:
31
10
2024
pubmed:
31
10
2024
entrez:
31
10
2024
Statut:
epublish
Résumé
Despite increases in musculoskeletal disorders (MSD) in Canada, evidence suggests utilization of chiropractic services has remained relatively stable over time. Understanding the extent to which chiropractors are consulted and factors associated with their utilization may suggest factors related to accessing care. We assessed the change in prevalence and characteristics of Canadians seeking chiropractic care across two time periods 2001-2010 and 2015-2018. We used national cross-sectional data from seven cycles of the Canadian Community Health Survey between 2001 and 2018. The survey included Canadians aged 12 years and older living in private dwellings in all provinces and territories. National annual weighted prevalence and age-standardized weighted prevalence (and 95% confidence intervals) of chiropractic utilization were calculated. We calculated prevalence of chiropractic utilization stratified by demographic, socioeconomic, lifestyle and health-related variables. Crude linear trends and change in prevalence from 2001 to 2010 were assessed using linear regression models. The national annual prevalence of Canadians consulting a chiropractor in the previous 12 months slightly increased from 11.0% (95% CI 10.8, 11.3) in 2001 to 11.4% (95%CI 11.1, 11.7) in 2010, and in those reporting receiving regular health care from a chiropractor from 7.5% (95%CI 7.2, 7.7) in 2015 to 7.9% (95%CI 7.7, 8.2) in 2018. Prevalence of utilization varied by province, highest in the Western provinces but lowest in Atlantic provinces. The age-specific prevalence of chiropractic utilization was highest in those aged 35-49 years and remained stable over time, except for slight increase in those aged 65-79 years. A higher percentage of Canadians identifying as white, Canadian-born, in the highest quintile of household income, overweight, physically active and in excellent health reported seeking chiropractic services. The most common reported chronic conditions measured in the survey among Canadians consulting chiropractors were chronic back problems, arthritis, fibromyalgia and headaches. The national prevalence of utilization of chiropractic services among Canadians slightly increased over time but varied by province and respondents' socioeconomic and health characteristics. Chronic back problems were the most common reported chronic condition. This comprehensive population-based study on chiropractic utilization in Canada can be used to inform decisions concerning health human resources and access to rehabilitation care for MSD.
Sections du résumé
BACKGROUND
BACKGROUND
Despite increases in musculoskeletal disorders (MSD) in Canada, evidence suggests utilization of chiropractic services has remained relatively stable over time. Understanding the extent to which chiropractors are consulted and factors associated with their utilization may suggest factors related to accessing care. We assessed the change in prevalence and characteristics of Canadians seeking chiropractic care across two time periods 2001-2010 and 2015-2018.
METHODS
METHODS
We used national cross-sectional data from seven cycles of the Canadian Community Health Survey between 2001 and 2018. The survey included Canadians aged 12 years and older living in private dwellings in all provinces and territories. National annual weighted prevalence and age-standardized weighted prevalence (and 95% confidence intervals) of chiropractic utilization were calculated. We calculated prevalence of chiropractic utilization stratified by demographic, socioeconomic, lifestyle and health-related variables. Crude linear trends and change in prevalence from 2001 to 2010 were assessed using linear regression models.
RESULTS
RESULTS
The national annual prevalence of Canadians consulting a chiropractor in the previous 12 months slightly increased from 11.0% (95% CI 10.8, 11.3) in 2001 to 11.4% (95%CI 11.1, 11.7) in 2010, and in those reporting receiving regular health care from a chiropractor from 7.5% (95%CI 7.2, 7.7) in 2015 to 7.9% (95%CI 7.7, 8.2) in 2018. Prevalence of utilization varied by province, highest in the Western provinces but lowest in Atlantic provinces. The age-specific prevalence of chiropractic utilization was highest in those aged 35-49 years and remained stable over time, except for slight increase in those aged 65-79 years. A higher percentage of Canadians identifying as white, Canadian-born, in the highest quintile of household income, overweight, physically active and in excellent health reported seeking chiropractic services. The most common reported chronic conditions measured in the survey among Canadians consulting chiropractors were chronic back problems, arthritis, fibromyalgia and headaches.
CONCLUSION
CONCLUSIONS
The national prevalence of utilization of chiropractic services among Canadians slightly increased over time but varied by province and respondents' socioeconomic and health characteristics. Chronic back problems were the most common reported chronic condition. This comprehensive population-based study on chiropractic utilization in Canada can be used to inform decisions concerning health human resources and access to rehabilitation care for MSD.
Identifiants
pubmed: 39478579
doi: 10.1186/s12998-024-00552-1
pii: 10.1186/s12998-024-00552-1
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
30Informations de copyright
© 2024. The Author(s).
Références
Cross M, Smith E, Hoy D, Nolte S, Ackerman I, Fransen M, et al. The global burden of hip and knee osteoarthritis: estimates from the global burden of disease 2010 study. Ann Rheum Dis. 2014;73(7):1323–30.
doi: 10.1136/annrheumdis-2013-204763
pubmed: 24553908
Hoy D, March L, Brooks P, Blyth F, Woolf A, Bain C, et al. The global burden of low back pain: estimates from the global burden of Disease 2010 study. Ann Rheum Dis. 2014;73(6):968–74.
doi: 10.1136/annrheumdis-2013-204428
pubmed: 24665116
Cieza A, Causey K, Kamenov K, Hanson SW, Chatterji S, Vos T. Global estimates of the need for rehabilitation based on the Global Burden of Disease study 2019: a systematic analysis for the global burden of Disease Study 2019. Lancet. 2020;396(10267):2006–17.
doi: 10.1016/S0140-6736(20)32340-0
pubmed: 33275908
pmcid: 7811204
Chen N, Fong DYT, Wong JYH. Secular trends in musculoskeletal rehabilitation needs in 191 countries and territories from 1990 to 2019. JAMA Netw Open. 2022;5(1):e2144198–e.
doi: 10.1001/jamanetworkopen.2021.44198
pubmed: 35044468
pmcid: 8771302
Angarita-Fonseca A, Trask C, Shah T, Bath B. Stable prevalence of chronic back disorders across gender, age, residence, and physical activity in Canadian adults from 2007 to 2014. BMC Public Health. 2019;19:1–11.
doi: 10.1186/s12889-019-7395-8
Hartvigsen J, Hancock MJ, Kongsted A, Louw Q, Ferreira ML, Genevay S, et al. What low back pain is and why we need to pay attention. Lancet. 2018;391(10137):2356–67.
doi: 10.1016/S0140-6736(18)30480-X
pubmed: 29573870
Kopec J, Cibere J, Sayre E, Li L, Lacaille D, Esdaile J. Descriptive epidemiology of musculoskeletal disorders in Canada: data from the global burden of disease study. Osteoarthr Cartil. 2019;27:S259.
doi: 10.1016/j.joca.2019.02.629
Power JD, Perruccio AV, Paterson JM, Canizares M, Veillette C, Coyte PC, et al. Healthcare utilization and costs for musculoskeletal disorders in Ontario, Canada. J Rhuematol. 2022;49(7):740–7.
doi: 10.3899/jrheum.210938
Aggarwal M, Hutchison B, Abdelhalim R, Baker GR. Building High-Performing Primary Care systems: after a Decade of Policy Change, is Canada walking the talk? Milbank Q. 2023;101(4):1139–90.
doi: 10.1111/1468-0009.12674
pubmed: 37743824
Casey S. Addressing Canada’s health workforce crisis. House Commons. 2023.
Duong D, Vogel L. National survey highlights worsening primary care access. Can Med Assoc; 2023.
Bath B, Lawson J, Ma D, Trask C. Self-reported use of family physician, chiropractor and physiotherapy services among adult canadians with chronic back disorders: an observational study. BMC Health Serv Res. 2018;18:1–11.
doi: 10.1186/s12913-018-3790-6
Shahaed H, Glazier RH, Anderson M, Barbazza E, Bos VL, Saunes IS, et al. Primary care for all: lessons for Canada from peer countries with high primary care attachment. CMAJ. 2023;195(47):E1628–36.
doi: 10.1503/cmaj.221824
pubmed: 38049161
pmcid: 10699311
Wong JJ, Lu M, Côté P, Watson T, Rosella LC. Effects of chiropractic use on medical healthcare utilization and costs in adults with back pain in Ontario, Canada from 2003 to 2018: a population-based cohort study. BMC Health Serv Res. 2023;23(1):793.
doi: 10.1186/s12913-023-09690-3
pubmed: 37491238
pmcid: 10367314
Coulter I, Schneider M, Egan J, Murphy D, Mior SA, Jacob G. Back Pain: Chiropractor’s View. Handb Spine Technol. 2021:37–65.
Beliveau PJ, Wong JJ, Sutton DA, Simon NB, Bussières AE, Mior SA, et al. The chiropractic profession: a scoping review of utilization rates, reasons for seeking care, patient profiles, and care provided. Chiropr Man Ther. 2017;25:1–17.
doi: 10.1186/s12998-017-0165-8
Lim KL, Jacobs P, Klarenbach S. A population-based analysis of healthcare utilization of persons with back disorders: results from the Canadian Community Health Survey 2000–2001. Spine. 2006;31(2):212–8.
doi: 10.1097/01.brs.0000194773.10461.9f
pubmed: 16418643
Canizares M, Hogg-Johnson S, Gignac MA, Glazier RH, Badley EM. Changes in the use practitioner-based complementary and alternative medicine over time in Canada: Cohort and period effects. PLoS ONE. 2017;12(5):e0177307.
doi: 10.1371/journal.pone.0177307
pubmed: 28494011
pmcid: 5426710
Wong JJ, Wang D, Hogg-Johnson S, Mior SA, Côté P. Prevalence and characteristics of healthcare utilization with different providers among canadians with chronic back problems: a population-based study. Brain Spine. 2024;4:102812.
doi: 10.1016/j.bas.2024.102812
pubmed: 38698804
pmcid: 11063586
Statement S. Strengthening the reporting of observational studies in epidemiology: STROBE checklists, 2009.
Statistics Canada. Canadian Community Health Survey (CCHS) – Annual component. https://www23.statcan.gc.ca/imdb/p2SV.pl?Function=getInstanceList&Id=1531795 (accessed Oct 20, 2018).
Statistics Canada. Tables 17-10-0005-01 Population estimates on July 1, by age and gender [Internet]. [cited March 1, 2021].
National Academies of Sciences, Medicine Division. Board on Health Care Services, Committee on Health Care Utilization, Disabilities. Aw. Health-care utilization as a proxy in disability determination. 2018.
Mior SA, Laporte A. Economic and resource status of the chiropractic profession in Ontario, Canada: a challenge or an opportunity. J Manip Physiol Ther. 2008;31(2):104–14.
doi: 10.1016/j.jmpt.2007.12.007
Piérard E. Substitutes or complements? An exploration of the effect of wait times and availability of conventional care on the use of alternative health therapies in Canada. Complement Ther Med. 2012;20(5):323–33.
doi: 10.1016/j.ctim.2012.06.001
pubmed: 22863647
Grier AR, Lepnurm R. Modeling a chiropractor: population ratio. J Manip Physiol Ther. 1995;18(7):464–70.
Stabile M, Ward C. The effects of delisting publicly funded health-care services. CM Beach et coll health services restructuring in Canada: new evidence and new directions. Montréal: McGill-Queen’s University; 2006. pp. 83–109.
Canizares M, Gignac M, Hogg-Johnson S, Glazier RH, Badley EM. Do baby boomers use more healthcare services than other generations? Longitudinal trajectories of physician service use across five birth cohorts. BMJ open. 2016;6(9):e013276.
doi: 10.1136/bmjopen-2016-013276
pubmed: 27687902
pmcid: 5051394
Laberge M, Coulibaly LP, Berthelot S, da Silva RB, Guertin JR, Strumpf E, et al. Development and validation of an instrument to measure health-related out-of-pocket costs: the cost for patients questionnaire. Value Health. 2021;24(8):1172–81.
doi: 10.1016/j.jval.2021.03.016
pubmed: 34372983
Bihrmann K, Pedersen MT, Hartvigsen J, Wodschow K, Ersbøll AK. Social inequity in chiropractic utilisation–a cross-sectional study in Denmark, 2010 and 2017. Chiropr Man Ther. 2024;32(1):27.
doi: 10.1186/s12998-024-00548-x
de Luca K, Hogg-Johnson S, Funabashi M, Mior S, French SD. The profile of older adults seeking chiropractic care: a secondary analysis. BMC Geriatr. 2021;21(1):271.
doi: 10.1186/s12877-021-02218-6
pubmed: 33892643
pmcid: 8066480
Southerst D, Bakaa N, Côté P, Macedo L, Carlesso L, MacDermid J, et al. Diversity of the chiropractic profession in Canada: a cross-sectional survey of Canadian Chiropractic Association members. Chiropr Man Ther. 2022;30(1):52.
doi: 10.1186/s12998-022-00463-z
Bakaa N, Southerst D, Côté P, Macedo L, Carlesso LC, MacDermid J, et al. Assessing cultural competency among Canadian chiropractors: a cross-sectional survey of Canadian Chiropractic Association members. Chiropr Man Ther. 2023;31(1):1.
doi: 10.1186/s12998-023-00474-4
MacIsaac S, Morency J-D, Malenfant CÉ. Immigration and Diversity: Population projections for Canada and its regions, 2011 to 2036. Statistics Canada; 2017.