Presenter: Jean Spinks (Monash University. Centre for Health Economics)
Discussant: Thomas MillerTexas A&M Health Science Center
Background: Complementary and alternative medicine (CAM) is an increasingly popular form of health care. It encompasses the use of CAM practitioners as well as many other therapies. Out-of-pocket expenditure on CAM in the United States is over $3 billion per year. However, the relationship between the use of conventional medicine and CAM by individuals is not well understood. This relationship has important implications for health policy makers and planners, particularly as governments and other third-party health insurers consider alternative, cost-effective measures to care for the increasing number of people living with chronic illness.
Aim: This study quantifies the relationship between the use of CAM practitioners, conventional medicine practitioners and prescription medicines in people with chronic conditions, taking into consideration relevant socioeconomic and demographic factors. We hypothesised that there is a positive correlation between CAM use and the use of conventional medicine practitioners and prescription medicines.
Data and Methods: Data from a large Panel Survey are used, incorporating 17 waves of data collection. The tested models include explanatory variables that allow identification of the effects of a range of factors on the use of the different types of therapies, including the role of a person’s socioeconomic and health status. Of particular interest is any correlation between private health insurance coverage and the utilisation of CAM, and whether CAM use would increase if coverage of CAM by private insurers increases, and which sections of society this will impact upon. By estimating a system of equations, we are also able to test the hypothesis of co-utilisation of both conventional and alternative medicines, allowing for correlation between the unobservables that influence both variables.
Results: Results demonstrate the likelihood of using CAM therapies given varying levels of conventional medicine use, as well as specific socio-economic characteristics of individuals. An income mediated effect is apparent however the direction of this trend is unexpected. Education levels also play a considerable, significant role. This has important implications for health policy research as providing health care for people living with chronic conditions is increasing important due to the increasing prevalence of diseases which can be controlled with lifestyle interventions.
Conclusion: The results are discussed within a health system policy framework. Given the high levels of expenditure on CAM, it is important to better understand the determinants of spending on this modality as compared to conventional medicine within different societal groups, location, gender and access to services, as CAM may offer an additional cost-effective alternative to conventional medicine services. The relevance and implications of these results for policy makers and other third-party health insurers provide thought-provoking alternatives with regard to the choice of health care modality by individuals, as well as the level and motivation for participation in private health insurance funds.
The 3rd Biennial Conference of the American Society of Health Economists took place at Cornell University.
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