Extent and structure of health insurance expenditures for complementary and alternative medicine in Swiss primary care.
BACKGROUND
The study is part of a nationwide evaluation of complementary and alternative medicine (CAM) in primary care in Switzerland. The goal was to evaluate the extent and structure of basic health insurance expenditures for complementary and alternative medicine in Swiss primary care.


METHODS
The study was designed as a cross-sectional evaluation of Swiss primary care providers and included 262 certified CAM physicians, 151 noncertified CAM physicians and 172 conventional physicians. The study was based on data from a mailed questionnaire and on reimbursement information obtained from health insurers. It was therefore purely observational, without interference into diagnostic and therapeutic procedures applied or prescribed by physicians. Main outcome measures included average reimbursed costs per patient, structured into consultation- and medication-related costs, and referred costs.


RESULTS
Total average reimbursed cost per patient did not differ between CAM physicians and conventional practitioners, but considerable differences were observed in cost structure. The proportions of reimbursed costs for consultation time were 56% for certified CAM, 41% for noncertified CAM physicians and 40% for conventional physicians; medication costs--including expenditures for prescriptions and directly dispensed drugs--respectively accounted for 35%, 18%, and 51% of costs.


CONCLUSIONS
The results indicate no significant difference for overall treatment cost per patient between CAM and COM primary care in Switzerland. However, CAM physicians treat lower numbers of patients and a more cost-favourable patient population than conventional physicians. Differences in cost structure reflect more patient-centred and individualized treatment modalities of CAM physicians.
Busato
Andre
A
Institute for Evaluative Research in Orthopaedic Surgery, University of Bern, Stauffacherstrasse 78, CH-3014 Bern, Switzerland. andre.busato@memcenter.unibe.ch
Eichenberger
Reiner
R
Künzi
Beat
B
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D000529:Complementary Therapies / Q000191:economics* / Q000706:statistics & numerical data; D005260:Female; D017048:Health Care Costs; D005102:Health Expenditures / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D007348:Insurance, Health / Q000706:statistics & numerical data*; D007349:Insurance, Health, Reimbursement / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D011320:Primary Health Care / Q000191:economics*; D012017:Referral and Consultation / Q000191:economics / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires; D013557:Switzerland