Evidence map›Paper›PMID 41645149›Full record

ArticleBMC health services research2026

Health care epidemiology, characteristics, and regional variation of chiropractic care in Switzerland: a descriptive study using insurance claims data.

Javier Muñoz Laguna, Lea S Rohner, Malin Mühlemann, Andri Signorell, Laura C Rosella, Milo A Puhan, Cesar A Hincapié

Abstract read
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Article in BMC health services research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

What it found

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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3 · Its place in the literature

Who cites it

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4 · The record

Corrections and comments

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5 · Who and what money

Authors and funding

7 authors.

Javier Muñoz Laguna *Musculoskeletal Epidemiology Research Group, Epidemiology, Biostatistics and Prevention Institute (EBPI) and University Spine Centre Zurich (UWZH), University of Zurich and Balgrist University Hospital, Zurich, Switzerland.ORCID http://orcid.org/0000-0003-0332-5540
Lea S Rohner *Musculoskeletal Epidemiology Research Group, Epidemiology, Biostatistics and Prevention Institute (EBPI) and University Spine Centre Zurich (UWZH), University of Zurich and Balgrist University Hospital, Zurich, Switzerland.ORCID http://orcid.org/0000-0002-2967-4688
Malin MühlemannMusculoskeletal Epidemiology Research Group, Epidemiology, Biostatistics and Prevention Institute (EBPI) and University Spine Centre Zurich (UWZH), University of Zurich and Balgrist University Hospital, Zurich, Switzerland.ORCID http://orcid.org/0000-0002-3669-1689
Andri SignorellHelsana Group, Zurich, Switzerland.ORCID http://orcid.org/0000-0003-4311-1969
Laura C RosellaDalla Lana School of Public Health, University of Toronto, Toronto, Canada.ORCID http://orcid.org/0000-0003-4867-869X
Milo A PuhanEpidemiology, Biostatistics and Prevention Institute (EBPI), University of Zurich, Zurich, Switzerland.ORCID http://orcid.org/0000-0003-4721-1879
Cesar A HincapiéMusculoskeletal Epidemiology Research Group, Epidemiology, Biostatistics and Prevention Institute (EBPI) and University Spine Centre Zurich (UWZH), University of Zurich and Balgrist University Hospital, Zurich, Switzerland. cesar.hincapie@uzh.ch.ORCID http://orcid.org/0000-0002-7257-8122

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundMusculoskeletal disorders are a leading cause of disability and major driver of health care costs in Switzerland. Since chiropractors are musculoskeletal health care providers in this setting, we aimed to describe the health care epidemiology, characteristics, and regional variation of chiropractic care in Switzerland.

methodWe conducted a retrospective descriptive study using administrative health insurance claims data of all ages from Helsana. Chiropractic care incidence cases were persons with first occurrence of chiropractic care in two study index years, 2018 and 2019. Chiropractic care prevalence cases had any chiropractic care over a 24-month prevalence period. We estimated (i) crude, (ii) sex-, age-, and region- standardised 12-month cumulative incidence, and (iii) 24-month prevalence of chiropractic care per 100,000 population. We characterised four mutually exclusive chiropractic care incidence subgroups based on additional health care use eight weeks before or after the index visit. Regional variation was visualised with choropleth maps.

resultsAmong 1,137,904 and 1,196,760 persons with Helsana health insurance in 2018 and 2019, 17,148 (mean age 48.7 [SD, 18.4] years; 9,717 [56.7%] women) and 18,261 (mean age 48.2 [SD, 18.2] years; 10,421 [57.0%] women) persons had a chiropractic care incidence visit, respectively. The crude 12-month chiropractic care incidence was estimated at 1,507 (95% CI, 1,485 to 1,530) and 1,526 (1,504 to 1,548) cases per 100,000 in 2018 and 2019, respectively. Sex-, age-, and region-standardised incidence estimates were comparable to crude estimates. The 24-month prevalence of chiropractic care was estimated at 3,135 (3,105 to 3,166) per 100,000 population. The chiropractic case subgroup with the highest health care use had more comprehensive insurance models with lower deductibles. Incidence of chiropractic care varied across regions with the lowest incidence observed in Ticino and the highest in Espace Mittelland and Zurich.

conclusionsThe incidence and prevalence of chiropractic care utilisation in Switzerland in 2018 and 2019 were markedly low. Chiropractic care subgroups differed in their characteristics, and incidence estimates varied across major regions. Further studies on the predictors and causes of chiropractic care underutilisation are warranted to inform accessible and equitable musculoskeletal and rehabilitation health services in Switzerland.

Indexed as

ChiropracticManipulation, ChiropracticMusculoskeletal DiseasesAdolescentAdultAgedChildChild, PreschoolFemaleHumansIncidenceInfantInfant, NewbornInsurance Claim ReviewMaleMiddle AgedChiropracticHealth administrative dataHealth care epidemiologyHealth care variationRegional variation

Identifiers

PMID41645149
PMCPMC12922438

What Socratic holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.