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

Arch Intern Med. 2002 Feb 11;162(3):281-7. doi: 10.1001/archinte.162.3.281.


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.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • Complementary Therapies / economics*
  • Complementary Therapies / statistics & numerical data*
  • Confidence Intervals
  • Female
  • Health Care Costs
  • Health Care Surveys
  • Humans
  • Insurance Coverage / statistics & numerical data*
  • Male
  • Middle Aged
  • Musculoskeletal Diseases / economics
  • Musculoskeletal Diseases / therapy
  • Neoplasms / economics
  • Neoplasms / therapy
  • Prevalence
  • Regression Analysis
  • Severity of Illness Index
  • Sex Factors
  • Surveys and Questionnaires
  • United States