Arch Intern Med. 2002 Feb; 162(3): 281-7.

Insurance coverage, medical conditions, and visits to alternative medicine providers: results of a national survey.

Wolsko PM, Eisenberg DM, Davis RB, Ettner SL, Phillips RS.

Center for Alternative Medicine Research and Education, Division of Primary Care, Beth Israel Deaconess Medical Center, Harvard Medical School, Libby 330, 330 Brookline Ave, Boston, MA 02215, USA. [email protected]

BACKGROUND: In 1997, patients made an estimated 629 million visits to complementary and alternative medicine (CAM) providers; however, little is known about factors associated with visits to CAM providers. OBJECTIVE: To examine the effect of insurance coverage on frequency of use of CAM providers. METHODS: We conducted a nationally representative, random household telephone survey of 2055 adults. MAIN OUTCOME MEASURE: The number of visits made to CAM providers. RESULTS: An estimated 44% of the US population used at least 1 CAM therapy in 1997. Of those using CAM, 52% had seen at least 1 CAM provider in the last year. Among those who used a CAM therapy, factors independently associated with seeing a provider were having been in the upper quartile of visits to conventional providers in the last year (adjusted odds ratio [AOR], 2.00; 95% confidence interval [CI], 1.33-3.01), female sex (AOR, 1.67; 95% CI, 1.17-2.38), and having used the therapy to treat diabetes (AOR, 5.20; 95% CI, 1.40-19.40), cancer (AOR, 2.99; 95% CI, 1.04-8.62), or back or neck problems (AOR, 1.51; 95% CI, 1.02-2.23). Factors independently associated with frequent use (. or = 8 visits per year) of a CAM provider were full insurance coverage of the CAM provider (AOR, 5.06; 95% CI, 2.45-10.47), partial insurance coverage (AOR, 3.26; 95% CI, 1.72-6.19), having used the therapy for wellness (AOR, 2.85; 95% CI, 1.63-4.98), and having seen the provider for back or neck problems (AOR, 2.26; 95% CI, 1.29-3.94). Conservative extrapolation to national estimates suggests that 8.9% of the population (17.5 million adults) accounted for more than 75% of the 629 million visits made to CAM providers in 1997. CONCLUSIONS: A small minority of persons accounted for more than 75% of visits to CAM providers. Extent of insurance coverage for CAM providers and use for wellness are strong correlates of frequent use of CAM providers.