Positive Health Online

Abstract

DRUSS and ROSENHECK, Department of Psychiatry, Yale University, West Haven, Conn USA benjamin.druss@yale.edu. write that the terms alternative and complementary medicine suggest 2 contradictory possibilities, including the use of unconventional therapies as a substitute or as an "add on" to conventional medical treatments. The authors conducted a survey to study the association between the use of unconventional therapies and conventional medical care within a national sample within the US.

Background

Methodology

The 1996 Medical Expenditure Panel Survey was distributed to some 32,000 noninstitutionalised, civilian people. 24,676 individuals responded (77.7% response rate), and some 16,000 adults aged 18 years or older were included in the analysis. The main outcome measures were: visits to practitioners for unconventional therapies and conventional medical treatments, including the number of visits to inpatient, outpatient and emergency department, and the use of 8 types of preventive medical services blood pressure, cholesterol level, physical examination, influenza vaccination, prostate examination, breast examination, mammography and Pap tests.

Results

In 1996, 6.5% of the US population visited both unconventional and conventional medical services. 1.8% used only unconventional services; 59.5% used only conventional care and 32.2% used neither. Compared with those individuals who used only conventional care, those people using both types of care had significantly more outpatient physician visits and used more of all types of preventive services except mammography. These groups did not significantly differ in their use of inpatient care, prescription drug use of number of visits to emergency departments. Those people in the top quartile of number of physician visits were more than twice as likely as those in the bottom quartile to have used unconventional therapies in the past year. This association between unconventional treatments and physician visits remained even after adjustments for potential confounders, and across differing types of unconventional treatments.

Conclusion

This survey demonstrated that use of unconventional therapies was substantially lower than has been reported in previous national surveys, but was associated with increased use of physician services. Hence, from a health services perspective, practitioner-based unconventional therapies appear to act more as a complement than an alternative to conventional medicine .

References

Druss BJ and Rosenheck RA. Association between use of unconventional therapies and conventional medical services. Jama 282(7): 651-6. 18 Aug 1999.