Study: Does CAM Access reduce health expenditure?
Study: Does CAM Access reduce health expenditure?
The present study is about using the health expenditure of people who use complementary and alternative medicine (cam) to compare people with people who do not. The study analyzes insurance claims from the US state of Washington for the period from 2000 to 2003. It was found that the average expenses of CAM users were lower than that of non-users. In particular, CAM users had higher outpatient expenses, which were, however, compensated for by lower expenses for inpatient treatments and imaging. CAM users paid an average of $ 1,420 less than non-users, especially in patients with high disease burden. However, it is emphasized that these lower costs can be related to visiting CAM doctors, which leads to other health and lifestyle factors. The study concludes with the indication that further investigations should be carried out in other regions and under other conditions.
Reference
lind bk, lafferty we, tyree pt, diehr pk. Comparison of health expenditure for insured users and non-users of complementary and alternative medicine in the US state of Washington: a cost minimization analysis. j Alternate complement med . 2010; 16 (4): 411-417.
Design
Analysis of the insurance claim data for 2000–2003 from the US state of Washington, which prescribes the coverage of complementary and alternative medicine (cam). Patients who used cam were given to those who did not do this, based on the age group, gender, index disease state, overall disease burden and previous year's expenditure.
results
"Both unavailed tests and linear regression models showed that CAM users had lower average than non-users. (Uninfigured: 3.79 β7 compared to β7 compared to 4.0001; β from linear regression-367 USD for cam users.) CAM users had higher outpatient expenses that Lower expenses for inpatient treatment and imaging were determined.
effects on practice
This paper is the latest in a series of this team for evaluating databases on insurance claims that arose in 1996 after an insurance connection mandate for CAM providers in the US state of Washington. The amendment of the regulations required the health insurance companies working in the state to grant all state -qualified health service providers access. Earlier work in the group showed that the overall demands were hardly influenced by the cover by CAM providers due to the less damage amounts compared to conventional medical requirements. These studies also showed that CAM users tend to have greater morbidity than non-users.
There are only a few cost studies in CAM research. Minimization of costs, the approach of this work, analyzes which of the two care approaches associated with lower total expenditure, under the assumption of comparable health results between the two approaches. "CAM users" were those who had claimed to visit one of the following CAM providers: acupuncture, chiropractor, massage therapists and naturopaths. In this analysis, the average damage costs were about 9 % lower for CAM users than for non-users, which shows lower inpatient and additional costs (e.g. imaging, laboratory), but higher outpatient visitor costs.
The consequences of the cost are favorable for the use of CAM providers, but are related to the visits of CAM providers set out in the requirements and are not demonstrably due to them. The lower costs of CAM users can be caused by other health and lifestyle factors associated with visiting CAM doctors (e.g. activation of a newly obtained patient in view of a chronic problem, waiving conventional medical interventions due to therapy failure).
Although the insurance coverage was made available by CAM providers, the insurance coverage generally did not correspond to that of the conventional providers and was limited between different insurance companies by restrictions on the number of CAM visits, a certain network of a provider or a total cost limit for CAM.
[Pulledquote]Not all CAM care costs are included in the data set; For example, dietary supplements that can be a necessary component of CAM treatment are usually not covered, even if this is the case when visiting the doctor. The analysis was carried out in three serious diseases - back pain, fibromyalgia and menopause - whose causes are all unclear. It is also diseases that often do not respond to conventional treatment, so that the results may not be transferred to all diseases. These diseases fall into the emerging research area of medically inexplicable physical syndromes (MUPs), in which the least hanging fruits for cam research goals can be found.
In order to answer the question of causality, prospective intervention studies are required. However, the assignment of patients in the comparison groups of users and non-users based on their entire medical claims in the year before the initiation of CAM applications suggests this study to a generalizable result in future economic analyzes. Patients without a year claims before the start of the CAM applications were not included in the analysis.
Different provider types were not distinguished in the analysis, since there was too few information for a provider type for a valid interpretation of the data according to discipline (personal communication with the first author). The study therefore offers consumers little orientation when choosing a provider, but rather the confidence that it could be a good choice to do something alternative. The damage costs in just one year were assessed; Savings from the CAM insert can go hand in hand with prevention, and later savings could not be addressed. The study did not include any patients covered by Medicaid, Medicare or State Programs-populations that may be more susceptible to improvements under CAM supply, since they have not had any access in the past.
Despite its restrictions, this creative use of existing data provides some evidence that the costs for CAM providers do not go beyond conventional care and that the use of CAM providers can be cost-saving. Since more such data has become available with the increasing inclusion and durability of CAM providers in insurance protection in the past decade, replication of this study in other regions and conditions is increasingly possible and should be carried out.