Trends in alternative medicine use in the United States, 1990-1997 - Results of a follow-up national survey
Trends in alternative medicine use in the United States, 1990-1997 - Results of a follow-up national survey
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DOI：
10.1001/jama.280.18.1569
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发表时间：
1998-11-11
影响因子：
120.7
通讯作者：
Kessler, RC
中科院分区：
文献类型：
--
作者：
Eisenberg, DM;Davis, RB;Kessler, RC
背景。-之前的一项全国性调查记录了1990年美国替代药物使用的高流行率和成本。目标-记录1990至1997年间美国替代药物使用的趋势，设计。-1991年和1997年进行了具有全国代表性的随机家庭电话调查，使用类似的关键问题，分别测量1990年和1997年的使用情况。参与者。-1991年的1539名成年人和1997年的2055名。主要结果衡量标准。-流行率，估计成本，结果：前一年16种替代疗法中至少有1种的使用率从1990年的33.8%上升到1997年的42.1%(P小于或等于.001)。增加最多的疗法包括草药、按摩、美维他命、自助小组、民间疗法、能量疗法和顺势疗法。使用者去看替代疗法的概率从36.3%增加到46.3%(P=0.002)，在这两项调查中，替代疗法最常用于慢性疾病，包括背部问题、焦虑、抑郁和头痛。在两个调查年度之间，披露比率没有显著变化；在1990年，39.8%的替代疗法向医生披露，而在1997年，38.5%的使用者完全自掏腰包为替代疗法医生提供的服务支付费用的百分比在1990年(64.0%)和1997年(58.3%)之间没有显著变化(P=.36)。对美国人口的推算表明，另类医学从业者的总就诊次数增加了47.3%，从1990年的4.27亿人次增加到1997年的6.29亿人次，从而超过了美国所有初级保健医生的就诊总数。据估计，1997年有1500万成年人在服用处方药的同时服用草药和/或大剂量维生素(占所有处方使用者的18.4%)。在1990至1997年间，另类医学专业服务的估计开支增加了45.2%，保守估计在1997年为212亿元，其中至少有122亿元是自付的。这超过了1997年所有美国住院患者的自付费用。与替代疗法有关的1997年自付支出总额保守估计为270亿美元，与1997年美国所有医生服务的预计自付支出相当。结论-替代疗法的使用和支出在1990至1997年间大幅增加，主要是由于寻求替代疗法的人口比例增加，而不是每个患者的就诊次数增加。
Context.-A prior national survey documented the high prevalence and costs of alternative medicine use in the United States in 1990.Objective.-To document trends in alternative medicine use in the United States between 1990 and 1997,Design.-Nationally representative random household telephone surveys using comparable key questions were conducted in 1991 and 1997 measuring utilization in 1990 and 1997, respectively.Participants.-A total of 1539 adults in 1991 and 2055 in 1997.Main Outcomes Measures.-Prevalence, estimated costs, and disclosure of alternative therapies to physicians.Results.-Use of at least 1 of 16 alternative therapies during the previous year increased from 33.8% in 1990 to 42.1% in 1997 (P less than or equal to.001). The therapies increasing the most included herbal medicine, massage, megavitamins, self-help groups, folk remedies, energy healing, and homeopathy. The probability of users visiting an alternative medicine practitioner increased from 36.3% to 46.3% (P = .002), In both surveys alternative therapies were used most frequently for chronic conditions, including back problems, anxiety, depression, and headaches. There was no significant change in disclosure rates between the 2 survey years; 39.8% of alternative therapies were disclosed to physicians in 1990 vs 38.5% in 1997, The percentage of users paying entirely out-of-pocket for services provided by alternative medicine practitioners did not change significantly between 1990 (64.0%) and 1997 (58.3%) (P = .36). Extrapolations to the US population suggest a 47.3% increase in total visits to alternative medicine practitioners, from 427 million in 1990 to 629 million in 1997, thereby exceeding total visits to all US primary care physicians. An estimated 15 million adults in 1997 took prescription medications concurrently with herbal remedies and/or high-dose vitamins (18.4% of all prescription users). Estimated expenditures for alternative medicine professional services increased 45.2% between 1990 and 1997 and were conservatively estimated at $21.2 billion in 1997, with at least $12.2 billion paid out-of-pocket. This exceeds the 1997 out-of-pocket expenditures for all US hospitalizations. Total 1997 out-of-pocket expenditures relating to alternative therapies were conservatively estimated at $27.0 billion, which is comparable with the projected 1997 out-of-pocket expenditures for all US physician services.Conclusions.-Alternative medicine use and expenditures increased substantially between 1990 and 1997, attributable primarily to an increase in the proportion of the population seeking alternative therapies, rather than increased visits per patient.