A longitudinal analysis of the chiropractic profession from 1996 to 2007

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Aim: To explore the relative attractiveness of chiropractic in Ontario, Canada from 1996-2007. Methods: We conducted a longitudinal cohort study using administrative registration data from 1996-2007. Stickiness and Inflow concepts acted as proxy measures for relative attractiveness. Survival analysis was employed to identify practitioner groups more likely to leave practice. Results: Chiropractors grew from 1,955 to 4,185 from 1996-2007 in Ontario. Increases occurred in the proportions of female, and foreign-trained chiropractors. Stickiness indicators averaged changes of 0.29/year from 1997-2003, but from 2004-2007 the average was 8 times greater, at 2.42 points/year. Survival analysis showed that certain groups, like newer practitioners were at greater risk of leaving practice (HRR 1.33, p<0.05; CI 1.04-1.73). However, time-varying analysis showed a post-delisting, increase in profession-wide likelihood of leaving. Conclusion: The chiropractic profession became less attractive in synchrony with government policy decisions. Following delisting in 2004, the likelihood of leaving practice increased for most chiropractors.
Chiropractic, Ontario, Health human resources, Health policy, Retention