ABSTRACT
OBJECTIVE: To ascertain the incidence of acupuncture claims and the characteristics of patients claiming for acupuncture. DESIGN: Secondary analysis of Health Insurance Commission data on claims for acupuncture performed by a medical practitioner. PARTICIPANTS: A summary of all Medicare acupuncture claims for financial years 1984-85 to 1996-97 and a random sample of patients claiming a Medicare rebate in calendar year 1996. MAIN OUTCOME MEASURES: Claims for acupuncture by patients' State, sex, age, and the socioeconomic disadvantage index of patients' residences. RESULTS: Between 1984-85 and 1996-97 the number of acupuncture claims increased, but declined as a proportion of total Medicare claims. In 1996, 1.16% of patients claimed for acupuncture, which constituted 0.5% of all Medicare claims. Adjusting for age and socioeconomic disadvantage, women were more likely than men to claim for acupuncture (odds ratio, 1.40; 95% confidence interval, 1.36-1.45). This sex difference is proportionately greater than that for all medical services. Propensity to claim for acupuncture increased with age, peaking at 65-69 years, then declining. Acupuncture claims were more likely in areas just above those assessed as having the greatest social disadvantage. CONCLUSION: The number of acupuncture claims has increased since 1984. As a proportion of all Medicare claims, acupuncture has remained stable since declining in 1991-92. This suggests that acupuncture is now an established complementary medical practice.
Subject(s)
Acupuncture Therapy , Family Practice , Insurance Claim Review , Acupuncture Therapy/statistics & numerical data , Adolescent , Adult , Age Factors , Aged , Aged, 80 and over , Australia/epidemiology , Child , Child, Preschool , Female , Humans , Incidence , Infant , Logistic Models , Male , Medicare , Middle Aged , Sex Factors , United StatesABSTRACT
OBJECTIVES: To ascertain the extent of the use of acupuncture and the characteristics of general practitioners using acupuncture. DESIGN: Secondary analysis of 1996 Health Insurance Commission data on claims by all non-specialist medical practitioners for Medicare Benefits Schedule items for an attendance where acupuncture was performed by a medical practitioner. MAIN OUTCOME MEASURES: Use of acupuncture by general practitioners and the practitioners' sex, age, place of primary medical qualification, and the socioeconomic disadvantage index of the practitioners' practice. RESULTS: 15.1% of general practitioners claimed for acupuncture. Acupuncture was more likely to be provided by male practitioners, by those aged 35-54 years, and by practitioners who have an overseas primary medical qualification. The socioeconomic index of the practice did not significantly affect the number of claims for acupuncture. CONCLUSION: Acupuncture is used by about one in seven general practitioners. Its use is associated with middle-aged practitioners, who presumably have more clinical experience. This level of use by experienced doctors suggests that a critical review of the appropriate role of acupuncture in general practice should be considered.
Subject(s)
Acupuncture Therapy/statistics & numerical data , Patient Care Team/statistics & numerical data , Adult , Aged , Australia , Family Practice/statistics & numerical data , Female , Humans , Insurance Claim Review/statistics & numerical data , Male , Middle Aged , National Health Programs/statistics & numerical data , Practice Patterns, Physicians'/statistics & numerical data , Socioeconomic FactorsABSTRACT
OBJECTIVE: To identify the non-specialist medical practitioner workforce engaged in active general practice in the region served by the Division of General Practice-Northern Tasmania and to determine the usefulness of public domain databases for enumeration of individual non-specialists providing general practice services. METHODS: A masterlist of the active general practice workforce was compiled by obtaining the names and addresses/postcodes of all non-specialist medical practitioners who were listed in at least one of nine public domain databases and who were confirmed by selected local medical practitioners to be in active general practice in the three months prior to 30 June 1994. This masterlist was used in calculating the sensitivity and positive predictive value (PPV) of each of the nine databases for enumerating non-specialist practitioners in active general practice. RESULTS: Combining the databases resulted in a list of 475 practitioners, which was refined to 139 practitioners who, by our criteria, were in active general practice. Databases had a range of sensitivities and PPVs, but those with high sensitivity tended to have low PPVs, and vice versa. The most useful database for enumerating these practitioners was the mailing list for Australian Family Physician (sensitivity, 94%; PPV, 0.79). CONCLUSIONS: When used alone, no single database had both high sensitivity and high positive predictive value for identifying the active general practice workforce. Combining multiple databases may improve precision. Developing methods to identify recent departures from local active practice has the potential to improve the PPV of existing highly sensitive databases.
Subject(s)
Databases, Factual/standards , Family Practice , Public Sector , Registries/standards , Australia , Humans , Insurance, Health , Laboratories , Periodicals as Topic , Reproducibility of Results , Sensitivity and Specificity , Societies, Medical , Tasmania , Telephone , WorkforceABSTRACT
The total blood lead levels of a group of 48 petrol vendors and a comparison group of 47 clerks and students were determined. The mean total blood lead level of the petrol vendors was 32-9 mug/100 ml (S.E.1-73 mug/100 ml). The mean level of the comparison group was 14-3 mug/100 ml (S.E. 0-72 mug/100 ml). The concentrations of lead in the blood of petrol vendors were significantly higher than those of the comparison group, and seven individual values fell above the currently accepted "level of concern". Recent relevant literature is reviewed.