The concentration of out-of-pocket expenditures on complementary and alternative medicine in the United States.
BACKGROUND
The most intense spenders on health services are considerably less healthy.49% report fair or poor health status compared to 15% of the general adult population and are elderly. Such findings have important implications for addressing national health-care spending because interventions targeting those people who are in poor health could theoretically generate dramatic cost savings. Although the popularity of complementary and alternative medicine (CAM) in the United States is well recognized, little is known about the distribution of out-of-pocket expenditures on CAM services.


OBJECTIVE
This study examined the distribution of out-of-pocket expenditures on CAM health services in the United States.


METHODS
The research team used data from the 2007 National Health Interview Survey to examine the distribution in the United States of out-of-pocket expenditures on CAM services and the characteristics of adult (age ≥ 18 years) CAM users (n = 2972) according to spending.


METHODS
Using complex survey-design methods, the research team generated national estimates of expenditures on CAM services and used linear regression adjusted for covariates to determine whether self-reported health status predicted CAM spending.


RESULTS
According to our estimates, in 2007, over 30 million adults reported out-of-pocket expenditures on CAM services, and of these individuals, 7.2 million were heavy CAM spenders with a mean annual expenditure of $1385. The highest quartile of CAM spenders accounted for $10 billion of the $13.9 billion spent nationally on CAM in 2007. Self-reported health status did not differ among groups with differing levels of CAM spending, β = 1.00 (95% CI, 0.8-1.2).


CONCLUSIONS
Out-of-pocket spending on CAM is concentrated. Just a quarter of CAM users account for over 70% of all expenditures on CAM services, and health status does not appear to be associated with level of CAM spending.
The Dartmouth Institute for Health Policy, Lebanon, NH, USA. matthew.a.davis@darmouth.edu
Matthew A
MA
Davis
William B
WB
Weeks
D000328:Adult; D000368:Aged; D000529:Complementary Therapies / Q000191:economics* / Q000706:statistics & numerical data; D005260:Female; D005382:Financing, Personal / Q000706:statistics & numerical data*; D015438:Health Behavior; D005102:Health Expenditures / Q000706:statistics & numerical data*; D006304:Health Status; D006801:Humans; D007182:Income / Q000706:statistics & numerical data; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D012651:Self Medication / Q000191:economics* / Q000706:statistics & numerical data; D012959:Socioeconomic Factors; D014481:United States / Q000453:epidemiology; D055815:Young Adult