Background Many people use unconventional therapies for healthproblems, but the extent of this use and the costs are not known.We conducted a national survey to determine the prevalence,costs, and patterns of use of unconventional therapies, suchas acupuncture and chiropractic.
Methods We limited the therapies studied to 16 commonly usedinterventions neither taught widely in U.S. medical schoolsnor generally available in U.S. hospitals. We completed telephoneinterviews with 1539 adults (response rate, 67 percent) in anational sample of adults 18 years of age or older in 1990.We asked respondents to report any serious or bothersome medicalconditions and details of their use of conventional medicalservices; we then inquired about their use of unconventionaltherapy.
Results One in three respondents (34 percent) reported usingat least one unconventional therapy in the past year, and athird of these saw providers for unconventional therapy. Thelatter group had made an average of 19 visits to such providersduring the preceding year, with an average charge per visitof $27.60. The frequency of use of unconventional therapy variedsomewhat among sociodemographic groups, with the highest usereported by nonblack persons from 25 to 49 years of age whohad relatively more education and higher incomes. The majorityused unconventional therapy for chronic, as opposed to life-threatening,medical conditions. Among those who used unconventional therapyfor serious medical conditions, the vast majority (83 percent)also sought treatment for the same condition from a medicaldoctor; however, 72 percent of the respondents who used unconventionaltherapy did not inform their medical doctor that they had doneso. Extrapolation to the U.S. population suggests that in 1990Americans made an estimated 425 million visits to providersof unconventional therapy. This number exceeds the number ofvisits to all U.S. primary care physicians (388 million). Expendituresassociated with use of unconventional therapy in 1990 amountedto approximately $13.7 billion, three quarters of which ($10.3billion) was paid out of pocket. This figure is comparable tothe $12.8 billion spent out of pocket annually for all hospitalizationsin the United States.
Conclusions The frequency of use of unconventional therapy inthe United States is far higher than previously reported. Medicaldoctors should ask about their patients' use of unconventionaltherapy whenever they obtain a medical history.
Source Information
From the Division of General Medicine and Primary Care, Department of Medicine, Beth Israel Hospital and Harvard Medical School, Boston (D.M.E., T.L.D.); the Institute for Social Research, University of Michigan, Ann Arbor (R.C.K., C.F.); the Division of General Medicine, Department of Medicine, New England Deaconess Hospital and Harvard Medical School, Boston (D.R.C.); and Chicago College for Osteopathic Medicine, Chicago (F.E.N.).
Address reprint requests to Dr. Eisenberg at the Division of General Medicine and Primary Care, Beth Israel Hospital, 330 Brookline Ave., Boston, MA 02215.
Unconventional Medicine
Amoils S., Korte D., Nelson C. F., Rosner A. L., Friedman R., Zuttermeister P., Benson H., Roter B., Meserole L., Rahlmann J., Santosh S., Stackhouse F. A., Dawson H. R., Stotland N. L., Gellert G. A., Campion T., Eisenberg D., Delbanco T., Kessler R., Campion E. W.
Extract |
Full Text
N Engl J Med 1993;
329:1200-1204, Oct 14, 1993.
Correspondence
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