title: Health care utilization among complementary and alternative medicine users in a large military cohort.
abstract: BACKGROUND
  Complementary and Alternative Medicine use and how it impacts health care utilization in the United States Military is not well documented. Using data from the Millennium Cohort Study we describe the characteristics of CAM users in a large military population and document their health care needs over a 12-month period. The aim of this study was to determine if CAM users are requiring more physician-based medical services than users of conventional medicine.
  
  
  METHODS
  Inpatient and outpatient medical services were documented over a 12-month period for 44,287 participants from the Millennium Cohort Study. Equal access to medical services was available to anyone needing medical care during this study period. The number and types of medical visits were compared between CAM and non-CAM users. Chi square test and multivariable logistic regression was applied for the analysis.
  
  
  RESULTS
  Of the 44,287 participants, 39% reported using at least one CAM therapy, and 61% reported not using any CAM therapies. Those individuals reporting CAM use accounted for 45.1% of outpatient care and 44.8% of inpatient care. Individuals reporting one or more health conditions were 15% more likely to report CAM use than non-CAM users and 19% more likely to report CAM use if reporting one or more health symptoms compared to non-CAM users. The unadjusted odds ratio for hospitalizations in CAM users compared to non-CAM users was 1.29 (95% CI: 1.16-1.43). The mean number of days receiving outpatient care for CAM users was 7.0 days and 5.9 days for non-CAM users (p < 0.001).
  
  
  CONCLUSIONS
  Our study found those who report CAM use were requiring more physician-based medical services than users of conventional medicine. This appears to be primarily the result of an increase in the number of health conditions and symptoms reported by CAM users.
authors.affiliation: Department of Defense Center for Deployment Health Research, Naval Health Research Center, San Diego, CA, USA. martin.white@med.navy.mil
authors.forename: Martin R
authors.initials: MR
authors.lastname: White
authors.forename: Isabel G
authors.initials: IG
authors.lastname: Jacobson
authors.forename: Besa
authors.initials: B
authors.lastname: Smith
authors.forename: Timothy S
authors.initials: TS
authors.lastname: Wells
authors.forename: Gary D
authors.initials: GD
authors.lastname: Gackstetter
authors.forename: Edward J
authors.initials: EJ
authors.lastname: Boyko
authors.forename: Tyler C
authors.initials: TC
authors.lastname: Smith
mesh_terms: D000328:Adult; D000553:Ambulatory Care / Q000706:statistics & numerical data*; D016009:Chi-Square Distribution; D015331:Cohort Studies; D015897:Comorbidity; D000529:Complementary Therapies / Q000706:statistics & numerical data*; D005260:Female; D006296:Health Services / Q000706:statistics & numerical data*; D006304:Health Status; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D008889:Military Personnel / Q000706:statistics & numerical data*; D016017:Odds Ratio; D014481:United States; D055815:Young Adult