The terms alternative and complementary medicine suggest 2 contradictory possibilities. Whether
individuals use unconventional therapies as a substitute for or as an "add
on" to conventional medical treatments is uncertain.
To determine the association between use of unconventional therapies
and conventional medical care in a national sample.
Design, Setting, and Participants
The 1996 Medical Expenditure Panel Survey was distributed to a probability
sample of the noninstitutionalized civilian US population. Of 24,676 individuals
responding (77.7% response rate), 16,068 adults 18 years or older were included
in the analysis.
Main Outcome Measures
Visits to practitioners for unconventional therapies and conventional
medical services, including number of inpatient, outpatient, and emergency
department visits and use of 8 types of preventive medical services (blood
pressure, cholesterol level, physical examination, influenza vaccination,
prostate examination, breast examination, mammography, and Papanicolaou test).
During 1996, an estimated 6.5% of the US population had visits for both
unconventional therapies and conventional medical care; 1.8% used only unconventional
services; 59.5% used only conventional care; and 32.2% used neither. Compared
with those with only conventional visits, those who used both types of care
had significantly more outpatient physician visits (7.9 vs 5.4; P<.001), and used more of all types of preventive services except
mammography. These groups did not differ significantly in inpatient care,
prescription drug use, or number of emergency department visits. Individuals
in the top quartile of number of physician visits were more than twice as
likely as those in the bottom quartile to have used unconventional therapies
in the past year (14.5% vs 6.4%; P<.001). The
association between unconventional treatments and physician visits remained
after adjusting for potential confounders and across different types of unconventional
In this sample, use of unconventional therapies was substantially lower
than has been reported in previous national surveys, but was associated with
increased use of physician services. From a health services perspective, practitioner-based
unconventional therapies appear to serve more as a complement than an alternative
to conventional medicine.