title: Frequency, predictors, and expenditures for pediatric insurance claims for complementary and alternative medical professionals in Washington State.
abstract: BACKGROUND
  This study describes the frequency, predictors, and expenditures for the use of complementary and alternative medicine (CAM) in an insured pediatric population.
  
  
  METHODS
  Washington state requires CAM-licensed medical professional coverage in private health insurance. We performed a cross-sectional analysis of services provided to children in 2002 by conventional professionals, chiropractors, naturopathic physicians, acupuncturists, and massage therapists. Both chi(2) tests and logistic regression analysis were used to identify statistically significant differences in use and explanatory factors.
  
  
  RESULTS
  Of 187 323 children covered by 2 large insurance companies, 156 689 (83.6%) had any claims during the year. For those with claims, 6.2% of children used an alternative professional during the year, accounting for 1.3% of total expenditures and 3.6% of expenditures for all outpatient professionals. We found that CAM use was significantly less likely for males (odds ratio, 0.91; 95% confidence interval, 0.87-0.95) and more likely for children with cancer, children with low back pain, and children with adult family members who use CAM. Visits to chiropractors or massage therapists nearly always yielded diagnoses of musculoskeletal conditions. In contrast, diagnoses from naturopathic physicians and acupuncturists more closely resembled those of conventional professionals.
  
  
  CONCLUSIONS
  Insured pediatric patients used CAM professional services, but this use was a small part of total insurance expenditures. We found that CAM use was more common among some children, depending on their sex, age, medical conditions, and whether they had an adult family member who used CAM. Although use of chiropractic and massage was almost always for musculoskeletal complaints, acupuncture and naturopathic medicine filled a broader role.
authors.affiliation: College of Management, Metropolitan State University, Minneapolis, MN, USA. billlaf@u.washington.edu
authors.forename: Allen
authors.initials: A
authors.lastname: Bellas
authors.forename: William E
authors.initials: WE
authors.lastname: Lafferty
authors.forename: Bonnie
authors.initials: B
authors.lastname: Lind
authors.forename: Patrick T
authors.initials: PT
authors.lastname: Tyree
mesh_terms: D000293:Adolescent; D016009:Chi-Square Distribution; D002648:Child; D002675:Child, Preschool; D000529:Complementary Therapies / Q000191:economics* / Q000706:statistics & numerical data; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007344:Insurance Claim Reporting / Q000191:economics* / Q000706:statistics & numerical data; D016015:Logistic Models; D008297:Male; D014861:Washington