title: Substitutes or complements? An exploration of the effect of wait times and availability of conventional care on the use of alternative health therapies in Canada.
abstract: OBJECTIVE
  We explore how alternative and complementary care use is affected by wait list length and availability of conventional care in Canada.
  
  
  METHODS
  We use data from the 2003 Canadian Community Health Survey, Statistics Canada and the Fraser Institute to explore the effect of longer wait times on the use of alternative therapies in general and for specific therapies: Registered Massage Therapy, Chiropractics, Physiotherapy, Homeopathy and Acupuncture.
  
  
  METHODS
  We use binary variables indicating whether the individual used various types of alternative care in the year preceding the survey.
  
  
  RESULTS
  Wait times for specialists are associated with lower probabilities of using alternative care, but the effect are usually not statistically significant. Longer wait times for non-emergency surgery are associated with lower probabilities of using alternative care when using data from CANSIM, but very small higher probabilities of using alternative care when using data from the Fraser Institute which includes wait times for treatments for other procedures than non-emergency surgery. We find positive but extremely small effects for total wait times from the Fraser Institute. Individuals reporting unmet health care needs are more likely to use alternative care while individuals who do not have a regular physician are less likely to use it.
  
  
  CONCLUSIONS
  Reporting unmet health care needs or no family physician have more of an impact on the use of alternative therapies than wait lists do. The evidence is not clear as to whether alternative care is sometimes used as a substitute to conventional care rather than a complement.
authors.affiliation: Department of Economics, University of Waterloo, 200 University Ave. W., Waterloo, Ontario, Canada. epierard@uwaterloo.ca
authors.forename: Emmanuelle
authors.initials: E
authors.lastname: Piérard
mesh_terms: D000047:Academies and Institutes; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002170:Canada; D000529:Complementary Therapies / Q000706:statistics & numerical data*; D005260:Female; D019538:Health Care Surveys; D006296:Health Services / Q000600:supply & distribution*; D006297:Health Services Accessibility; D006301:Health Services Needs and Demand; D006801:Humans; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D014850:Waiting Lists; D055815:Young Adult