Shifting Economics of CAM Use

A post recently on Medscape highlighted the results of a study conducted through the University of Texas Pan-American and published by the Journal of Health Care for the Poor and Underserved (online abstract is here).

It compared NHS data from 2002 and 2007. It found that CAM use (especially chiropractic and massage) had increased substantially by non-Hispanic whites–as their utilization of mainstream health services went down, and even as they reported deferred or unsought medical care for existing ‘medical conditions.’

More than a third of respondents who used CAM reported an ‘unmet medical need or delayed getting medical care.’ Among the factors identified was the cost of medical care, and speculation in the study is that the economic accessibility of CAM providers in smaller offices, even if their services are uncovered by conventional insurance plans, contributed to driving up utilization. The lead author, Dr. Su, a sociologist at UTPA, wonders in print if people will continue to seek out CAM services if insurance reform covers more people.

So this raises an interesting question about the economic dynamics of health care. Do people seek out CAM as substitution services because of the economics in contrast to conventional (but covered) care? Or are they seeking out CAM as substitution services because of the effectiveness of the services? In other words, is it a business model or a clinical effectiveness question?

Interesting for all concerned.

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