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The Association of Complementary and Alternative Medicine Use and Health Care Expenditures for Back and Neck Problems

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The Association of Complementary and Alternative Medicine Use and Health Care Expenditures for Back and Neck Problems

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SOURCE: Med Care. 2012 (Dec); 50 (12): 1029–1036

The Geisel School of Medicine at Dartmouth & Dartmouth-Hitchcock Medical Center, Department of Orthopaedics, Lebanon, NH


BACKGROUND:   Health care costs associated with use of complementary and alternative medicine (CAM) by patients with spine problems have not been studied in a national sample.

OBJECTIVES:   To estimate the total and spine-specific medical expenditures among CAM and non-CAM users
with spine problems.

RESEARCH DESIGN:   Analysis of the 2002-2008 Medical Expenditure Panel Survey.

SUBJECTS:   Adults (above 17 y) with self-reported neck and back problems who did or did not use CAM services.

MEASURES:   Survey-weighted generalized linear regression and propensity matching to examine penditure differences between CAM users and non-CAM users while controlling for patient, socioeconomic, and health characteristics.

RESULTS:   A total of 12,036 respondents with spine problems were included, including 4306 (35.8%) CAM users (40.8% in weighted sample). CAM users had significantly better self-reported health, education, and comorbidity compared with non-CAM users.

Adjusted annual medical costs among CAM users was $424 lower (95% confidence interval: $240, $609; P<0.001) for spine-related costs, and

$796 lower (95% confidence interval: $121, $1470; P=0.021) for total health care cost than among non-CAM users.

Average expenditure for CAM users, based on propensity matching, was $526 lower for spine-specific costs (P<0.001) and $298 lower for total health costs (P=0.403). Expenditure differences were primarily due to lower inpatient expenditures among CAM users.

CONCLUSIONS:   CAM users did not add to the overall medical spending in a nationally representative sample with neck and back problems. As the causal associations remain unclear in these cross-sectional data, future research exploring these cost differences might benefit from research designs that minimize confounding.

About the Author:

I was introduced to Chiro.Org in early 1996, where my friend Joe Garolis helped me learn HTML, the "mark-up language" for websites. We have been fortunate that journals like JMPT have given us permission to reproduce some early important articles in Full-Text format. Maintaining the Org website has been, and remains, my favorite hobby.

3 Comments

  1. Dr. Claar November 18, 2012 at 10:22 pm

    It is great to see options available to lower health care costs and get people healthier using less invasive procedures.

  2. Adam M Schotzko November 20, 2012 at 10:20 am

    Every chiropractor knows this to be true especially when the chronic neck or back pain patient who have tried everything else and thousands of dollars in the medical model, come see us and get quick relief from chiropractic care.

  3. The old bromide
    chiropractic first
    medicine second
    surgery last
    still rings true

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