Comparison of health care expenditures among insured users and nonusers of complementary and alternative medicine in Washington State: a cost minimization analysis.

Objectives: The purpose of this analysis was to compare health care expenditures between insured patients with back pain, fibromyalgia syndrome, or menopause symptoms who used complementary and alternative medical (CAM) providers for some of their care to a matched group of patients who did not use any CAM care. Insurance coverage was equivalent for both conventional and CAM providers.

Design: Insurance claims data for 2000-2003 from Washington State, which mandates coverage of CAM providers, were analyzed.

Chiropractic use by urban and rural residents with insurance coverage.

Purpose: To describe the use of chiropractic care by urban and rural residents in Washington state with musculoskeletal diagnoses, all of whom have insurance coverage for this care. The analyses investigate whether restricting the analyses to insured individuals attenuates previously reported differences in the prevalence of chiropractic use between urban and rural residents as well as whether differences in provider availability or patient cost-sharing explain the difference in utilization.

Methods: Claims data from 237,500 claimants in 2 large insurance companies in Washington state for calendar year 2002 were analyzed, using adjusted clinical group risk adjustment for differences in disease burden and rural urban commuting area codes for rurality definition.

Complementary and alternative medicine provider use and expenditures by cancer treatment phase.

Objective: To assess the use of complementary and alternative medicine (CAM) providers and the associated expenditures by specific treatment phases among patients with cancer.

Study Design: Cross-sectional analysis of medical services utilization and expenditures during the 3 therapeutic phases of initial, continuing, and end-of-life life treatment.

Methods: Analysis of an insurance claims database that had been matched to the Washington State Surveillance, Epidemiology, and End Results cancer registry.

Maternal work and birth outcome disparities.

Objectives: We tested relations between aspects of maternal work and birth outcomes in a national sample and in subgroups known to experience disparities.

Methods: Three indices of work attributes (Status and Recognition, Physical Demands, and Exposure to Conflict) were derived by factor analysis of variables extracted from the Department of Labor's O*Net database. The indices were linked to the National Longitudinal Survey of Youth using occupation codes for the primary jobs held by women who gave birth between 1979 and 2000 and worked during the quarter prior to birth (n = 3,386 births to n = 2,508 mothers).

Use of complementary and alternative medicine providers by fibromyalgia patients under insurance coverage.

Objective: To quantify how visits and expenditures differ between insured patients with fibromyalgia syndrome (FMS) who visit complementary and alternative medicine (CAM) providers compared with patients with FMS who do not. Patients with FMS were also compared with an age- and sex-matched comparison group without FMS.

Methods: Calendar year 2002 claims data from 2 large insurers in Washington state were analyzed for provider type (CAM versus conventional), patient comorbid medical conditions, number of visits, and expenditures.

The effect of complementary and alternative medicine claims on risk adjustment.

Objective: We sought to assess how the inclusion of claims from complementary and alternative medicine (CAM) providers affects measures of morbidity burden and expectations of health care resource use for insured patients.

Methods: Claims data from Washington State were used to create 2 versions of a case-mix index. One version included claims from all provider types; the second version omitted claims from CAM providers who are covered under commercial insurance.

Complementary and alternative provider use by insured patients with diabetes in Washington State.

Objectives: The authors investigated whether insurance coverage for complementary and alternative medicine (CAM) providers is associated with increased medical care use among diabetes patients. Predictors of CAM use and how CAM affects health care use and expenditures under insurance coverage were examined.

Design: Claims data from two large insurers in Washington State were obtained for 2002.