PHP65 - Examining Costs, Utilization, and Driving Factors of Complementary and Alternative Medicine (CAM) Services

Abstract

This study examined types of complementary and alternative medicine (CAM) services used by patients and further evaluated factors that predict CAM service use. Retrospective database analyses were conducted using currently available nationally representative Medical Expenditure Panel Survey (MEPS) Database. CAM utilization was defined as any office visit by an adult 18 years or older to a chiropractor, acupuncturist, massage therapist, homeopathic / naturopathic / herbalist, or other alternative / complementary care. CAM services utilization and costs were determined by compiling the data into a single data file, and likely predictors of CAM service utilization were determined by literature research and bivariate analysis. A predictor model was created using backwards stepwise logistic regression. Data analyses were completed using SAS version 9.3, with significance set at 0.05. There were 21,275,251 (8.83%) adults identified with at least one CAM services office visit, with a mean of 7.8 (± 0.32) office visits per person, and the mean cost of each office visit was $686.99 (± $37.41). The majority of office visit payments was out of pocket and represented 56% of total visit costs. The service most used was chiropractic (15,067,047), (6.26%), followed by massage therapy (5,460,039), (2.27%) and acupuncture (2,045,187), (0.85%). Statistically significant variables from a logistic regression model predicting CAM use, ordered from highest significance to lowest were: presence of back or spine injury, race, region, income, comorbidity score, employment status, SF-12 scores, age, BMI, health insurance coverage, and hospitalization. About 8.8% of the adult population visited a CAM provider, a lower estimate compared to prior publications, and about 42% of those that visited a CAM office paid more than 80% out of pocket. In addition, those without health insurance were 50% more likely to seek CAM provider care, suggesting there could be implications regarding health insurance coverage and utilization of CAM services.