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Abstract #162985

Richard S. Lockwood, MPH, School of Community Health, Portland State University, P.O. Box 751, Portland, OR 97207, 5037259089, lockwood@pdx.edu

The development of Integrative Medicine (IM) draws attention to the boundaries between allopathic medicine and CAM on several levels: conceptual, organizational and interactional. Systematic reviews found “large numbers” of physicians referring or practicing some forms of CAM, yet the rigor of “surveys using national, representative samples” was solicited (Astin et al. 1998).

The 1996 & 1998 Medical Expenditure Panel Surveys (MEPS) asked respondents about receipt of CAM from allopathic physicians (MDCAM) but sample sizes were small. These surveys were combined to increase multivariate statistical power [N=36,777; MDCAM (n=86)], representing a subpopulation of 992,097 Americans. MDCAM is conceptualized as boundary work (Lamont & Molnar 2002, Tilly 2004) and reflects aspects of internal differentiation within professions (Abbott 1988).

Preliminary analysis found that compared with users of conventional services, recipients of MDCAM were older (45.7 yrs vs. 37 yrs), more likely to be female (70.4% vs. 55%), white (84.9% vs. 79.7%), high school educated (85.8% vs. 78.5%), uninsured (18.2% vs. 7%). MDCAM recipients tended to be less healthy; poor self-rated physical health (7% vs. 3.3%), poor self-rated mental health (3.0% vs. 1.5%), need for help with IADLs (6.7% vs. 5.4%). Interestingly, MDCAM recipients needed less help with ADLs (1.5% vs. 2.9%).

Compared to conventional services, the geographic distribution of MDCAM was less likely in the Northeast (9% vs. 20.3%), and Midwest (14.2% vs. 23.5%). These services were more likely in the South (38.2% vs. 36%), and West (38.6% vs. 20.1%).

Multivariate analyses will be presented for frequency of utilization of specific CAM therapies.

Learning Objectives: At the conclusion of the session, the participant (learner) in this session will be able to

• Identify a source of secondary-data which includes measures of physician provided complementary and alternative medicine (MDCAM) in a population-based survey.
• Identify relevant theoretical issues related to internal differentiation within professions.
• Articulate differences in the subpopulations of respondents who used conventional care only, CAM only, both and MDCAM.

Keywords: Alternative Medicine/Therapies, Health Care Utilization

Presenting author's disclosure statement:

Any relevant financial relationships? No
Any institutionally-contracted trials related to this submission?

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.