title: Out-Of-Pocket Expenditures on Complementary Health Approaches Associated With Painful Health Conditions in a Nationally Representative Adult Sample.
abstract: National surveys suggest that millions of adults in the United States use complementary health approaches such as acupuncture, chiropractic manipulation, and herbal medicines to manage painful conditions such as arthritis, back pain, and fibromyalgia. Yet, national and per person out-of-pocket (OOP) costs attributable to this condition-specific use are unknown. In the 2007 National Health Interview Survey, the use of complementary health approaches, the reasons for this use, and the associated OOP costs were captured in a nationally representative sample of 5,467 adults. Ordinary least square regression models that controlled for comorbid conditions were used to estimate aggregate and per person OOP costs associated with 14 painful health conditions. Individuals using complementary approaches spent a total of $14.9 billion (standard error [SE] = $.9 billion) on these approaches to manage these painful conditions. Total OOP expenditures by those using complementary approaches for their back pain ($8.7 billion, SE = $.8 billion) far outstripped OOP expenditures for any other condition; the majority of these costs ($4.7 billion, SE = $.4 billion) were for visits to complementary providers. Annual condition-specific per person OOP costs varied from a low of $568 (SE = $144) for regular headaches to a high of $895 (SE = $163) for fibromyalgia.
  
  
  CONCLUSIONS
  Adults in the United States spent $14.9 billion on complementary health approaches (eg, acupuncture, chiropractic manipulation, and herbal medicines) to manage painful conditions including back pain ($8.7 billion). This back pain estimate is almost one-third of the total conventional health care expenditure for back pain ($30.4 billion) and two-thirds higher than conventional OOP expenditures ($5.1 billion).
authors: National Center for Complementary and Integrative Health, National Institutes of Health, Bethesda, Maryland. Electronic address: nahinr@mail.nih.gov.
authors: Richard L
authors: RL
authors: Nahin
authors: National Center for Complementary and Integrative Health, National Institutes of Health, Bethesda, Maryland.
authors: Barbara J
authors: BJ
authors: Stussman
authors: RAND Health, RAND Corporation, Santa Monica, California.
authors: Patricia M
authors: PM
authors: Herman
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000529:Complementary Therapies / Q000191:economics*; D005260:Female; D005102:Health Expenditures / Q000706:statistics & numerical data*; D006801:Humans; D016018:Least-Squares Analysis; D008297:Male; D008875:Middle Aged; D059408:Pain Management / Q000191:economics*; D014481:United States / Q000453:epidemiology; D055815:Young Adult
keywords: Complementary and alternative medicine; back pain; chronic pain; expenditures; out-of-pocket costs