Complementary and alternative medicine (CAM): do barriers to and dissatisfaction with traditional care affect CAM utilization patterns

The purpose of this study is to determine whether dissatisfaction with and barriers to traditional health care led to higher odds of complementary alternative medicine (CAM) use among the U.S. adult population. It was hypothesized that difficulty obtaining care would lead to higher odds of CAM use among the general population, and that poorer access to and dissatisfaction with an individual's usual source of care (USC) would lead to higher odds of CAM use among those with a USC.

Data was extracted from the 1996 Medical Expenditure Panel Survey. Two subsamples of approximately 15,337 and 11,896 individuals were taken from the total sample population of 22,601 individuals in order to test the two hypotheses. Andersen's Behavioral Model of Health Services Use was used as the theoretical framework for the organization of the study data.

Univariate and multivariate logistic regression analyses were conducted using the survey and subpopulation commands in the STATA statistical software package. Alpha for the univariate analyses was set at 0.25. When testing whether difficulty obtaining traditional care led to higher odds of CAM use, the following variables were found to be significant: being between the ages of 25-44, 45-64, and 65-90, female, black or "other" race, unemployed, having a greater than high school education, earning more than 200% of the poverty line, being in fair or poor health, having Medicare or Other Public Insurance A, experiencing difficulty obtaining traditional care, and having diabetes, HIV, or arthritis. Results from the multivariate analyses showed that those who experienced difficulty obtaining care had 85% higher odds of CAM use than those who did not experience difficulty accessing the health care system.

Among those with a USC, significant variables at the univariate level included being between the ages of 25-44, 45-64, and 65-90, female, black, unemployed, having a greater than high school education, earning more than 200% of the poverty line, being in fair or poor health, having Medicare, finding it very or somewhat difficult to get an appointment with the USC on short notice, feeling as though the USC does not listen and provide needed health information, and having HIV, diabetes or arthritis. Mutlivariate analysis revealed that those who found it somewhat or very difficult to make an appointment with the USC on short notice had 28% higher odds of CAM use. However, the analysis also showed that those who felt as though their USC did not listen or provide needed health information were 53% less likely to utilize CAM therapies.

This study serves to demonstrate how barriers to the traditional health care system affect CAM utilization patterns among the U.S. adult population. The examination of these results could lead to a better understanding of why people employ altemative healthcare approaches and what issues specifically associated with accessing the Western medical system lead patients to seek alternative healthcare means. By determining which barriers to traditional care seem most predictive of CAM use, policy makers could focus their attention on alleviating such matters, thus ensuring better access to healthcare for the U.S. population.