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Major role of complementary and alternative medicine (CAM) for back pain management in Washington State

Bonnie K. Lind, MS1, William E. Lafferty, MD2, Karen J. Sherman, PhD, MPH3, Patrick T. Tyree, AA2, Richard A. Deyo, MD, MPH4, and Daniel C. Cherkin, PhD3. (1) Health Services, University of Washington, 146 N. Canal St. Suite 300, UW Box 358853, Seattle, WA 98103-8652, 206-685-0576, bklind@u.washington.edu, (2) Department of Health Services, University of Washington, Box 357660, Seattle, WA 98195, (3) Center for Health Studies, Group Health Cooperative, 1730 Minor Ave. #1600, Seattle, WA 98101-1498, (4) Center for Cost and Outcomes Research, University of Washington, 146 N. Canal St Suite 300, UW Box 358853, Seattle, WA 98103-8652

Objectives: Back pain (BP) is the second most common cause of doctor’s office visits. This study looks at the extent of CAM provider use for back pain treatment.

Methods: Washington State requires all commercial insurance to cover visits to chiropractors, massage therapists, acupuncturists, and naturopathic physicians. 2002 claims from two large Washington State insurers were analyzed by BP ICD-9 codes and provider type.

Results: These companies spent approximately $52 million for outpatient BP treatment. 104,358 adults submitted 652,593 claims related to BP. 424,499 (65%) of the claims were for visits to CAM providers, with 75% of those visits to chiropractors and 25% to naturopathic physicians, acupuncturists, or massage therapists. Most people used either CAM (43%) or conventional providers (45%) in BP management; 12% used both types of providers. Although “CAM only” users had nearly twice as many visits, (mean 7.1, s.d. 8.4) as the “Conventional only” group (3.6, 5.0), the average amounts allowed for all BP claims per person were $342 for those using CAM only compared to $507 for those using Conventional only. Those that used both were most expensive costing $1079 per year.

Conclusion: Most people used only CAM providers or only conventional care to manage their BP. Although persons using only CAM providers made almost twice as many visits as those using only conventional care, their costs of care were about 30% lower. Costs of back care for those using both CAM and conventional care were about 2-3 times as high as the costs for CAM or conventional care alone.

Learning Objectives:

Keywords: Alternative Medicine/Therapies,

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

Managing Chronic Pain with Alternative and Complementary Health Practices

The 132nd Annual Meeting (November 6-10, 2004) of APHA