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医保覆盖下纤维肌痛患者对补充和替代医学服务提供者的使用情况。

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

作者信息

Lind Bonnie K, Lafferty William E, Tyree Patrick Timothy, Diehr Paula K, Grembowski David E

机构信息

University of Washington, Seattle, and Boise State University, Boise, Idaho 83725, USA.

出版信息

Arthritis Rheum. 2007 Feb 15;57(1):71-6. doi: 10.1002/art.22471.

Abstract

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.

RESULTS

Use of CAM by patients with FMS was 2.5 times higher than in the comparison group without FMS (56% versus 21%). Patients with FMS who used CAM had more health care visits than patients with FMS not using CAM (34 versus 23; P < 0.001); however, CAM users had similar expenditures to nonusers among patients with FMS ($4,638 versus $4,728; not significant), because expenditure per CAM visit is lower than expenditure per conventional visit. Patients with FMS who used CAM also had heavier overall disease burdens than those not using CAM.

CONCLUSION

With insurance coverage, a majority of patients with FMS will visit CAM providers. The sickest patients use more CAM, leading to an increased number of health care visits. However, CAM use is not associated with higher overall expenditures. Until a cure for FMS is found, CAM providers may offer an economic alternative for patients with FMS seeking symptomatic relief.

摘要

目的

量化与未就诊于补充和替代医学(CAM)提供者的纤维肌痛综合征(FMS)参保患者相比,就诊于CAM提供者的FMS参保患者的就诊次数和费用有何不同。还将FMS患者与年龄和性别匹配的无FMS对照组进行比较。

方法

分析了华盛顿州两家大型保险公司2002年日历年的理赔数据,包括提供者类型(CAM与传统医疗)、患者合并的医疗状况、就诊次数和费用。

结果

FMS患者使用CAM的比例比无FMS的对照组高2.5倍(56%对21%)。使用CAM的FMS患者比未使用CAM的FMS患者有更多的医疗就诊次数(34次对23次;P<0.001);然而,在FMS患者中,使用CAM的患者与未使用者的费用相似(4638美元对4728美元;无显著差异),因为每次CAM就诊的费用低于每次传统就诊的费用。使用CAM的FMS患者的总体疾病负担也比未使用CAM的患者更重。

结论

在有保险覆盖的情况下,大多数FMS患者会就诊于CAM提供者。病情最严重的患者使用更多的CAM,导致医疗就诊次数增加。然而,使用CAM与更高的总体费用无关。在找到治愈FMS的方法之前,CAM提供者可能为寻求症状缓解的FMS患者提供一种经济的选择。

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