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. 2018 Sep 1;8(8):e023770.
doi: 10.1136/bmjopen-2018-023770.

The role of osteopathy in the Swiss primary health care system: a practice review

Paul Vaucher  1 , Roy J D Macdonald  1 , Dawn Carnes  1
Affiliations

The role of osteopathy in the Swiss primary health care system: a practice review

Paul Vaucher et al. BMJ Open. .

Abstract

Objectives: The aim of this study was to describe osteopathic activity and scope of practice to understand the current and future role of osteopathy in the Swiss healthcare system.

Design: A questionnaire survey that included a patient record-based retrospective clinical audit.

Setting/population: Osteopaths with a national diploma (n=1086) were invited by mail to participate in an online survey. Osteopathic assistants (n=84) were identified through their national association.

Questionnaire: The survey was constructed from previous surveys and tested for face validity with experts, osteopaths and patient representatives. The questionnaires were completed online in English, German and French between April and August 2017. Osteopaths anonymously reported information about themselves, their practice, and the treatment and care for four randomly selected patients they managed in 2016.

Results: The response rate from the survey was 44.5% (521/1171). Data on osteopathic care were collected for 1144 patients and 3449 consultations. In 2016, osteopaths saw approximately 6.8% of the Swiss population for 1700 000 consultations and an overall estimated cost of 200 million Swiss francs. 76% of patients sought care directly without a referral from another care provider. Few osteopaths (<1%) work in a hospital setting and 46% work in isolation in private practice. Infants (under 2 years old) made up 10% of all patients and 9% of patients were ≥65 years. Patients most commonly sought treatment for musculoskeletal conditions (81%) with the spine being the most frequent location (66%). Treatments also included exercise advice (34.2%) and lifestyle management (35.4%). Fewer than 1 patient out of 10 were referred to another health profession or provider.

Conclusions: In Switzerland, osteopathic care represents an important first line management for musculoskeletal conditions that alleviates some of the burden of care in the Swiss primary healthcare system.

Keywords: Switzerland; clinical audit; osteopathic care; scope of practice; survey.

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Conflict of interest statement

Competing interests: The researchers work for the Unit of Research in Mobility at the School of Health Sciences Fribourg which includes the division of osteopathy.

Figures

Figure 1
Figure 1
Flow chart illustrating data source for the practice review. GDK-CDS, Swiss Conference of Cantonal Health Directors.
Figure 2
Figure 2
Age and male to female estimated distribution of osteopaths in Switzerland.
Figure 3
Figure 3
Age profile of patients. Age of infants are given in months (A), those for children and adolescents (B) and adults (C) in years.
Figure 4
Figure 4
Type and frequency of conditions addressed by osteopaths (n=1144). The figure is trunked for musculoskeletal pain to scale other types of complaints. More than one condition could be reported per patient.
Figure 5
Figure 5
Proportion of patients (n=1144) having received specific treatments by osteopaths. High velocity low amplitude (HVLA), Osteopathic manipulative treatment  (OMT)
See this image and copyright information in PMC

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