Complementary and Alternative Medicine公共卫生学系.ppt

Complementary and Alternative Medicine 公共衛生學系 丁志音 副教授 名詞與概念 Unorthodox Marginal Unconventional Unofficial Outside biomedicine Nonscientific Orthodox Mainstream Conventional Official Inside biomedicine Scientific From Alternative to Complementary to Integrative Alternative 除此之外、其他的、非我族類 次要的、非正統的 、非正式的 Residual definitions are seldom satisfactory (Wardwell, 1994:1061) Complementary 補充的、輔助的 定義 What is not taught in medical schools or not covered by insurance (Eisenberg et al., 1993) Interventions neither taught widely in medical schools nor generally available in U.S. hospitals (Eisenberg et al., 1998) Every strategy of healing outside mainstream medicine (Blecourt and Usborne, 1999) Use David M. Eisenberg (1993, 1998) 1990 1997 Use in previous year 33.8% 42.1% Probability of visit CAM 36.3% 46.3% Disclosure 39.8% 38.5% Entire out-of-pocket payment 64.0% 58.3% Total visit(extrapolation, million) 47.3%↑ 427 629 Total CAM professional exp (billion)( 45.2%↑) 21.2 Out-of-pocket ( all US hospitalization) 12.2 Total out-of-pocket CAM expenditure (billion) 27.0 (=out-of-pocket for US physician service) Medical education in US AMA (1996-1997 survey) 46 school Wetzel et al. (1997-1998 survey) Elective/topics in required courses 75 school Total courses 123 Formats Lectures Practitioner lecture/demonstration Patients presentation Topics chiropractic, acupuncture, homeopathy, herbal therapy, mind-body techniques AMA (1999-2000 survey)