title: Chiropractic consultation requests in the Veterans Affairs Health Care System: demographic characteristics of the initial 100 patients at the Western New York medical center.
abstract: OBJECTIVE
  The objectives of this study were to review the demographic characteristics of Veterans Affairs (VA) chiropractic patients and to determine the level of appropriateness of chiropractic consultation requests within a VA chiropractic clinic. Information regarding the volume of requests and wait times for appointments were obtained to provide insight on the demand for and access to VA chiropractic services.
  
  
  METHODS
  A purposive sample of the first 100 chiropractic consultation requests received through the Computerized Patient Record System at the VA of Western New York Health Care System was selected for data collection and analysis.
  
  
  RESULTS
  The VA chiropractic patients in this study were primarily older men with chronic low-back pain that had not responded to medical management and other treatment modalities. More than half of the patients had service-connected disabilities. Consultation requests came largely from primary care, and most requests were for patients for whom chiropractic was clinically indicated and requested preconsultation diagnostic studies had been performed.
  
  
  CONCLUSIONS
  The VA chiropractic patients in this study differed from traditional non-VA chiropractic patients with regard to age and sex. A review of the chiropractic consultation requests that were considered inappropriate resulted in a revision of the instructions for requesting providers within the Computerized Patient Record System. Additional health systems research is indicated to evaluate chiropractic implementation on a larger scale within the VA Health Care System.
authors.affiliation: Veterans Affairs of Western New York Health Care System, Buffalo, NY 14215, USA. andrew.dunn@med.va.gov
authors.forename: Andrew S
authors.initials: AS
authors.lastname: Dunn
authors.forename: Jamie J
authors.initials: JJ
authors.lastname: Towle
authors.forename: Patrick
authors.initials: P
authors.lastname: McBrearty
authors.forename: Suzanne M
authors.initials: SM
authors.lastname: Fleeson
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D000554:Ambulatory Care Facilities; D002684:Chiropractic; D002908:Chronic Disease; D003710:Demography; D006233:Persons with Disabilities; D005260:Female; D006787:Hospitals, Veterans; D006801:Humans; D017116:Low Back Pain / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009518:New York; D011320:Primary Health Care; D012017:Referral and Consultation / Q000706:statistics & numerical data; D019233:Retreatment; D017678:Sex Distribution; D014481:United States; D014493:United States Department of Veterans Affairs / Q000706:statistics & numerical data; D014728:Veterans