Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Aug;58(8):689-695.
doi: 10.1097/MLR.0000000000001343.

Associations Between Complementary and Alternative Medicine and Health Care Expenditures Among Adults With Chronic Back Pain

R Henry Olaisen  1
Affiliations

Associations Between Complementary and Alternative Medicine and Health Care Expenditures Among Adults With Chronic Back Pain

R Henry Olaisen. Med Care. 2020 Aug.

Abstract

Background: Although complementary and alternative medicine (CAM) has been associated with reduced morbidity among adults with chronic back pain, less is known about the association between CAM use and health care expenditures.

Objectives: The objective of this study was to first estimate health care expenditures of adult CAM users and nonusers with chronic back pain and then assess CAM's influence on health care expenditures.

Research design: This was an ambidirectional cohort study.

Data: Linked National Health Interview Survey (2012) and Medical Expenditure Panel Survey (2013-2014).

Measures: CAM use was defined as 3 or more visits to a practitioner in the 12 months before the National Health Interview Survey interview. Covariates included age, sex, race-ethnicity, and body mass index. The outcome was annual health care expenditures (overall and within 8 categories, including office-based visits and prescription medication).

Analyses: Survey-weighted, covariate adjusted predicted marginal means models were applied to quantify health care expenditures. Survey-weighted, covariate adjusted linear and logistic regression models were used to investigate CAM's influence on expenditures, and the Z mediation test statistic was applied to quantify the independent effects of CAM.

Results: Overall, health care expenditures were significantly lower among CAM users with chronic back pain compared with non-CAM users for both 2013 and 2014: $8402 versus $9851 for 2013; $7748 versus $10,227 in 2014, annual differences of -$1499 (95% confidence interval: -$1701 to -$1197) and -$2479 (95% confidence interval: -$2696 to -$2262), respectively (P<0.001). Adult CAM users also had significantly lower prescription medication as well as outpatient expenses (P<0.001). CAM use was identified as a partial mediator to health care expenditures.

Conclusion: CAM use is associated with lower overall health care expenditures, driven primarily by lower prescription and outpatient expenditures, among adults with chronic back pain in the United States.

PubMed Disclaimer

References

    1. Dahlhamer J, Lucas J, Zelaya C, et al. Prevalence of chronic pain and high-impact chronic pain among adults—United States, 2016. MMWR Surveill Summ. 2018;67:1001–1006.
    1. Kennedy J, Roll JM, Schraudner T, et al. Prevalence of persistent pain in the US adult population: new data from the 2010 national health interview survey. J Pain. 2014;15:979–984.
    1. Henschke N, Kamper SJ, Maher CG. The epidemiology and economic consequences of pain. Mayo Clin Proc. 2015;90:139–147.
    1. Department of Health and Human Services. 5-point Strategy to Combat the Opioid Crisis; 2017. Available at: www.hhs.gov/opioids/sites/default/files/2018-09/opioid-fivepoint-strateg.... Accessed November 16, 2019.
    1. McCubbin T, Kempe KL, Beck A. Complementary and alternative medicine in an integrated health care delivery system: users of chiropractic, acupuncture, and massage services. Perm J. 2017;21:168–172.

Publication types

Grants and funding