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

The Chiro.Org Blog

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.