title: Use of traditional medicine and complementary and alternative medicine in Taiwan: a multilevel analysis.
abstract: As the selection of a medical modality is not completely independent, environmental and sociocultural contexts of ecological validity are desired. This study aimed to apply a multilevel analysis using the Hierarchical Linear Modeling software to examine predictors of traditional medicine (TM)/complementary and alternative medicine (CAM) use in Taiwan on both individual and division levels. Individual-level data were obtained from the government database involving TM/CAM use and its impact on the population, whereas division-level data were obtained from a government annual report. A total of 2310 individuals from 22 administrative divisions of Taiwan were evaluated in the data analysis, of which 86.9% had used at least 1 TM/CAM modality in the past year. The average division of TM/CAM use was 2.86 modalities in the null model and 4.15 in the full model. Significant relationships were found between TM/CAM use and individual-level variables of gender, educational level, monthly income, perceived health status, experience with Western medical treatment, and the cost, effect, and degree of satisfaction with TM/CAM. At the division level, TM/CAM use was significantly related to aging population, employment status, and the number of medical institutions. With a simultaneous evaluation of the individual-level and division-level influences, it was found that the average division of TM/CAM use increased significantly. The place of residence is an important predictor of TM/CAM use. The age factor in predicting TM/CAM use in this study may be overestimated in the population of 26 to 60 years of age, whereas an aging population is important in the average division of TM/CAM use. Efforts to reform health insurance to completely cover the costs of TM/CAM and to better facilitate equality of access of health care in rural and remote areas are deemed necessary.
authors: School of Nursing, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan, ROC (Drs Yeh, Lin, and Wang); Department of Applied Mathematics, Chung-Yuan Christian University, Taoyuan, Taiwan, ROC (Dr Chen); Department of Nursing, Chang Gung University of Sciences and Technology, Taoyuan, Taiwan, ROC (Dr Wang); and Hengshan Township Public Health, Hsinchu, Taiwan, ROC (Ms Huang).
authors: Mei-Ling
authors: ML
authors: Yeh
authors: Kuan-Chia
authors: KC
authors: Lin
authors: Hsing-Hsia
authors: HH
authors: Chen
authors: Yu-Jen
authors: YJ
authors: Wang
authors: Yu-Chiao
authors: YC
authors: Huang
mesh_terms: D000293:Adolescent; D000328:Adult; D000529:Complementary Therapies / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008519:Medicine, Traditional / Q000706:statistics & numerical data*; D008875:Middle Aged; D055361:Multilevel Analysis; D012959:Socioeconomic Factors; D013624:Taiwan / Q000453:epidemiology; D055815:Young Adult