title: The supply of complementary and alternative medicine in Swiss hospitals.
abstract: OBJECTIVE
  Over the past few years, a considerable increase in complementary and alternative medicine (CAM) has been observed, particularly in primary care. In contrast little is known about the supply of CAM in Swiss hospitals. This study aims at the investigation of amount and structure of CAM activities of Swiss hospitals.
  
  
  METHODS
  We designed a cross-sectional survey using a 2-step, questionnaire- based approach acquiring overview information form hospital managers in a first questionnaire leading to detailed information on CAM usage at medical department level (head of department). This second questionnaire provides data of physician-based and non-physician-based CAM supply.
  
  
  RESULTS
  The size of hospitals was significantly associated with the provision of CAM. 33% of the hospital managers indicated 1 or more medical doctor (MD) using CAM in their hospital compared to 37% of confirmation on department level (Kappa value 0.5). Mostly different CAM methods were applied. Acupuncture was used most frequently. However only 13 hospitals (11%) occupied more than 3 CAM MDs and only 5 hospitals had more than 2 full-time equivalents for MDs. Furthermore, 74.7% of these personnel resources were dedicated for outpatient care. In terms of CAM methods anthroposophic medicine accounted for more than half of the total personnel costs. On the other hand usage of non-physician based CAM accounted for 41% according to hospital managers compared to 64% of CAM usage according to medical departments (Kappa values 0.31). Reflexology of the foot was used most frequently.
  
  
  CONCLUSIONS
  Total supply of CAM in Swiss hospitals is low and concentrates on few hospitals. Acupuncture is the widest spread discipline but anthroposophic medicine spends the most resources. The study shows that a high patient demand for CAM faces low supply in hospitals.
authors.affiliation: Institute for Evaluative Research in Orthopaedic Surgery, University of Bern, Switzerland. marcel.widmer@MEMcenter.unibe.ch
authors.forename: Marcel
authors.initials: M
authors.lastname: Widmer
authors.forename: Andreas
authors.initials: A
authors.lastname: Dönges
authors.forename: Victoria
authors.initials: V
authors.lastname: Wapf
authors.forename: André
authors.initials: A
authors.lastname: Busato
authors.forename: Sylvia
authors.initials: S
authors.lastname: Herren
mesh_terms: D015670:Acupuncture Therapy / Q000706:statistics & numerical data; D000887:Anthroposophy; D000529:Complementary Therapies / Q000145:classification / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D019538:Health Care Surveys; D006276:Health Facility Size; D006301:Health Services Needs and Demand / Q000639:trends; D006761:Hospitals / Q000706:statistics & numerical data*; D006801:Humans; D008405:Massage / Q000706:statistics & numerical data; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D016730:Program Development; D011795:Surveys and Questionnaires; D013557:Switzerland; D016896:Treatment Outcome