Aspects of quality of primary care provided by physicians certified in phytotherapy in Switzerland.

Institute of Complementary Medicine, Department of Internal Medicine, University Hospital Zurich, Switzerland.
Forschende Komplementärmedizin / Research in Complementary Medicine (Impact Factor: 1.65). 05/2008; 15(2):82-8. DOI: 10.1159/000122031
Source: PubMed

ABSTRACT Data on the use of phytotherapy in primary care are scarce and difficult to compare (e.g. different health-care systems, study designs). OBJECTive: Are there differences in Switzerland regarding demographic data, practice structure, process of care and outcome/ treatment satisfaction between primary care physicians certified in phytotherapy (CAM) and physicians performing conventional primary care (COM) and their patients?
Subgroup analysis of the data of phytotherapy of an observational study (2 cross-sectional surveys with 3 questionnaires) which was performed as part of a nationwide evaluation program on complementary medicine (PEK). A descriptive analysis was used to compare data.
In survey A, 20 CAM and 191 COM physicians participated, of which 14 and 84, respectively, continued for survey B and recruited at least 276 CAM and 1,395 COM patients. Findings show that CAM physicians had less technical equipment (e.g. x-rays) than COM physicians, their consultation time was 25% longer, and they used more non-drug therapies. Whereas in the SF-36 no differences could be identified between the groups, the EUROPEP showed significant differences in favour of CAM patients.
Preliminary data of the comparison between CAM and COM physicians indicate few differences in demographic and practice structure data. Yet, due to differences in the process of care CAM patients showed better treatment satisfaction than COM patients. This is probably due to their doctors' communicative qualities and patient-oriented skills. To which degree this might be triggered due to phyto-pharmacosemiotic aspects needs to be investigated in a future study.

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    ABSTRACT: From 1999 to 2005, 5 methods of complementary and alternative medicine (CAM) applied by physicians were provisionally included into mandatory Swiss basic health insurance. Between 2012 and 2017, this will be the case again. Within this process, an evaluation of cost-effectiveness is required. The goal of this study is to compare practice costs of physicians applying CAM with those of physicians applying solely conventional medicine (COM). The study was designed as a cross-sectional investigation of claims data of mandatory health insurance. For the years 2002 and 2003, practice costs of 562 primary care physicians with and without a certificate for CAM were analyzed and compared with patient-reported outcomes. Linear models were used to obtain estimates of practice costs controlling for different patient populations and structural characteristics of practices across CAM and COM. Statistical procedures show similar total practice costs for CAM and COM, with the exception of homeopathy with 15.4% lower costs than COM. Furthermore, there were significant differences between CAM and COM in cost structure especially for the ratio between costs for consultations and costs for medication at the expense of basic health insurance. Patients reported better quality of the patient-physician relationship and fewer adverse side effects in CAM; higher cost-effectiveness for CAM can be deduced from this perspective. This study uses a health system perspective and demonstrates at least equal or better cost-effectiveness of CAM in the setting of Swiss ambulatory care. CAM can therefore be seen as a valid complement to COM within Swiss health care.
    Forschende Komplementärmedizin / Research in Complementary Medicine 01/2011; 18(6):315-20. · 1.65 Impact Factor
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    Forschende Komplementärmedizin / Research in Complementary Medicine 11/2012; Vol 19, suppl 2(12):9-17.


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Aug 11, 2014