Relaxation, massage Arthritis Chiropractic, massage High blood pressure Using less conservative cific books, classes, and equipment, the used were discussed with a medical doc- RVRBS price figures, the amount spent totalout-of-pocketexpendituresforalter- tor.
Using the aver- and had a medical doctor, only This ditures for practitioners of alternative vative estimates Table 5 , the estimated is not significantly different from the therapies are estimated to have increased total out-of-pocket expense is approxi- Given that Estimated out-of-pocket expenditures penditures for all physician services.
Unlike the survey, the chelation therapy. The ditures for alternative therapy services component of the alternative medicine decrease in overall response rate from are shown in Table 4.
The majority of market in is shown in Figure 2. Furthermore, due in part to small sample sizes. Lifestyle diet 0. Moreover, the use of alterna- Subtotal of out-of-pocket Price estimates for spiritual healing by others were not included because respondents reporting use were not asked resentative of the more conventional ie, for details of professional visits. This increase it is not surprising to find that nearly 1 in ternative therapy use eg, income, edu- appears to be primarily due to increases 5 individuals taking prescription medi- cation, age, region.
It is conceivable that in the prevalence of use and in the fre- cations also was taking herbs, high-dose the estimated prevalence and costs of al- quency with which users of alternative vitamin supplements, or both.
Extrapo- ternative therapy use would have been therapy sought professional services. In lations to the total US population sug- lower if it were possible to correct for , an estimated 4 in 10 Americans used gest that an estimated 15 million adults those limitations.
This figure includes nearly 3 alternative therapy use among African 7. The use of alterna- million adults aged 65 years or older. Complementary Med Res.
The use of alternative treatments in the Finnish or efficacy, are known to occur and therapies unique to minority populations adult population. No strategies. Only then can we compare Stoughton; Preva- adequate mechanism currently is in patterns across ethnic groups and pri- lence and cost of alternative medicine in Australia.
As alternative medicine is Fisher P, Ward A. Complementary medicine in potential for drug-herb and drug-vita- introduced by third-party payers as an Europe. Sermeus G. Alternative health care in Belgium. The magnitude of the demand for al- unfair for individuals without health in- Bouchayer F. Alternative medicines. Comple- ternative therapy is noteworthy, in light surance and those with less expendable mentary Med Res. Piel E. Erfahrungen mit Naturheilmitteln-Um- coverage for these services.
Unlike hos- native medical services or consultation frageergebnisse aus West-und Ostdeutschland. Millar WJ. Use of alternative health care prac- ternative therapies are only infrequently ance of alternative therapies.
Can J Public Health. Even In conclusion, our survey confirms US Bureau of the Census. United States popu- lation estimates, by age, sex, race, and Hispanic ori- they tend to have high deductibles and ditures have increased dramatically gin, to In light of these ob-.
Because the de- agencies, private corporations, founda- verter. Salt Lake City, Utah: mand for health care and presumably al- tions, and academic institutions adopt a Medicode Inc; Consumer much patients must pay out-of-pocket,28 implementation of clinical and basic sci- Price Index—All Urban Consumers.
US Bureau of current use is likely to underrepresent ence research, the development of rel- Labor Statistics Web site. Version 7. In , a full third of respondents who and the establishment of postmarket Research Triangle Park, NC: Research Triangle In- used alternative therapy did not use it surveillance of drug-herb and drug- stitute; Schappert SM.
National Ambulatory Medical for any principal medical condition. Care Survey: Summary. Woodwell DA. Hyattsville, Md: prevention. Germeshausen Foun- Butler Robb Scholten for their technical assistance. Ernst E. Harmless herbs? An increasing Participants. The therapies increas- fer courses on alternative medicine. The probability of users visiting an the United States suggest that alterna- alternative medicine practitioner increased from In both tive medicine is popular throughout the industrialized world.
There was no signifi- therapies during the prior 12 months has cant change in disclosure rates between the 2 survey years; Extrapolations to the US population suggest a This exceeds the out-of-pocket definitions of alternative therapy and the expenditures for all US hospitalizations.
Total out-of-pocket expenditures re- selection of therapies assessed. The purpose of this follow-up tially between and , attributable primarily to an increase in the proportion national survey was to investigate this presumption and document trends in al- of the population seeking alternative therapies, rather than increased visits per ternative medicine prevalence, costs, patient.
Eisenberg, MD, Center for Alter- tion from the media, the medical com- and A national survey of alter- stitutional Review Board, Boston, Mass. All rights reserved. Eligibility Commer- was limited to English speakers in whom weighted overall response rate among eli- cial diet programs were described as cognitive or physical impairment did not gible respondents.
We including trying to lose or gain weight on asked respondents about their use of al- Interview your own. We consider the results of the sented as a survey conducted about the ics. The was explained using the examples of February , representative of The sampling scheme was designed about perceived health, health worries, The remaining 9 therapies were asked with a target sample of in and days spent in bed, and functional impair- about without interviewer clarification.
The latter sample size was ment due to health problems. The actual numbers of practor or other nonmedical doctor. No financial incentive during the previous 12 months. This variation in cooperation eg, by region of ditions and were then asked about seeing was required because of expansion in country and urbanicity and for household a medical doctor for these principal medi- both the number of alternative thera- variation in probability of selection ie, the cal conditions and about the perceived pies we assessed in and questions inverse relationship between size of quality of these interactions.
The data were household and probability of selection be- dents were asked about their lifetime and weighted to adjust for this sampling in cause only 1 interview was completed in past month use of 16 alternative thera- making comparisons with the data. The data were pies and whether each of these therapies then weighted in parallel on sociodemo- was used for each of the principal medical Insurance Coverage graphic variables to adjust for aggregate conditions.
The survey also asked For each therapy for which respon- discrepancies between the sample distri- about use for a representative sample of dents said they used services of an alter- butions and population distributions pro- other medical conditions and expanded native medicine practitioner, we asked vided by the US Census Bureau.
This last the list of therapies beyond the original whether insurance helped pay for any of stage of weighting was based on the 16 assessed in Based on the answers to these to remove any between-survey discrep- use without such supervision. Respon- questions, we calculated the proportion of ancies of weighted sociodemographic dis- dents who reported supervised use were users of each therapy who had complete, tributions.
We de- then asked if they had discussed their use pies accounted for by that therapy. Construction of Cost Measures because of cognitive or physical incapac- Prior use of 16 targeted therapies was The total cost of visits to alternative ity. Among the remaining eligible explored using a computer-assisted in- medicine practitioners was calculated by respondents, A total of viewers made clear that the survey massage therapy, chiropractic care, Extrapolating this cluding a daily vitamin or vitamin pre- ery techniques, commercial diet, folk rem- JAMA, November 11, —Vol , No.
As the data in Table 1. Extrapolations of survey esti- Male 48 48 52 ance paid the full price of the visit. Characteristics of Respondents Hispanic 10 11 6 We calculated costs based on per-visit The characteristics of the subjects we Asian 1 4 1 prices chosen from typical prices paid for interviewed are shown in Table 1. The Other 4 1 2 such services by private insurers using a sociodemographic characteristics of the Education Resource-Based Relative Value Scale survey sample are similar to the popu- ,High school 14 18 24 RBRVS 16 system in selected states.
We lation distributions published by the US High school 37 34 35 then recalculated costs using a second set Bureau of the Census. Total costs of society. Use was more North central 24 24 32 ditures. People aged 35 to 49 years re- age out-of-pocket expenditures reported ported higher rates of use In , each respondent who younger Use was per in Use was meditation.
Among those who reported these other items were calculated follow- more common among those in the West using energy healing, the most frequently ing the same procedures used for herbs, With the ex- nets. Other modalities common to this ucts. Out-of-pocket expenditures on ception of observed sex differences in category included Therapeutic Touch, herbs, megavitamins, commercial diet , these patterns are consistent with Reiki, and energy healing by religious products, and related items were based those identified in The use of self-prayer, in contrast on actual dollar amounts reported, so Population prevalence estimates of al- to spiritual or energy healing performed changes between and include ternative medicine use in and by others, was investigated in terms of inflation.
To isolate the increase in the are shown in Table 2. The survey prevalence of use but not in terms of cost of practitioner visits between estimated that All analyses in this article the use of alternative therapies, we cal- least 1 of the 16 alternative therapies exclude data involving self-prayer.
The differences between the that this proportion increased signifi- significantly higher proportion of alter- and costs of practitioner services re- cantly to A native therapy users saw an alternative ported are understated because they do comparison of specific therapies in the medicine practitioner in The largest people.
Of the 15 therapies for which increases were in the use of herbal medi- the question was asked, the proportion Statistical Analysis cine, massage, megavitamins, self-help of users who saw a practitioner in- Analyses reported herein consist of groups, folk remedies, energy healing, creased for However, even in computation of prevalence and mean es- and homeopathy.
Megavitamins 5. Extrapolations to the US population suggest a Estimated expenditures for alternative medicine professional services increased This exceeds the out-of-pocket expenditures for all US hospitalizations.
Conclusions: Alternative medicine use and expenditures increased substantially between and , attributable primarily to an increase in the proportion of the population seeking alternative therapies, rather than increased visits per patient. Abstract Context: A prior national survey documented the high prevalence and costs of alternative medicine use in the United States in Publication types Research Support, Non-U.
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