Shih Shu-Fang, Lew-Ting Chih-Yin, Chang Hsing-Yi, Kuo Ken N
Center for Health Policy Research and Development, National Health Research Institutes, Zhunan Town, Miaoli County, Taiwan.
Soc Sci Med. 2008 Oct;67(7):1183-9. doi: 10.1016/j.socscimed.2008.06.011. Epub 2008 Jul 22.
Complementary and alternative medicine (CAM) has been characterized by prevalence, cost, and patterns of use. Factors determining its utilization have also been analyzed, either generally or for specific diseases, but few studies have considered the determinants of its frequency of use. Taiwan's pluralistic health care system and comprehensive insurance program covering Western medicine and traditional Chinese medicine (TCM) provide an interesting case to explore what forms of CAM people use, why and how often they use them. By using Taiwan's 2001 National Health Interview Survey and linking it with National Health Insurance (NHI) claims data, this study aims to investigate the socio-demographic, economic, behavioral and health determinants of use and frequency of use for both non-covered and covered CAM in Taiwan. The former consists of services practiced by non-regulated or non-NHI contracted practitioners and the latter includes those TCM covered by NHI. Our study showed that the determinants of using non-covered and covered CAM differ with respect to socio-demographic and behavioral factors, and health needs. Our evidence suggests that future CAM research must delineate between use and frequency of use to better understand the underlying factors contributing to initiation and continuity of CAM use.
补充和替代医学（CAM）的特点在于其流行程度、成本和使用模式。人们也对决定其使用的因素进行了分析，这些分析或是针对整体情况，或是针对特定疾病，但很少有研究考虑其使用频率的决定因素。台湾多元化的医疗保健体系以及涵盖西医和中医（TCM）的综合保险计划，为探究人们使用何种形式的补充和替代医学、为何使用以及使用频率提供了一个有趣的案例。通过利用台湾2001年国民健康访问调查，并将其与国民健康保险（NHI）理赔数据相联系，本研究旨在调查台湾未涵盖和已涵盖的补充和替代医学使用及使用频率的社会人口统计学、经济、行为和健康决定因素。前者包括由未受监管或未与国民健康保险签约的从业者提供的服务，后者包括国民健康保险涵盖的那些中医服务。我们的研究表明，在社会人口统计学、行为因素和健康需求方面，使用未涵盖和已涵盖的补充和替代医学的决定因素有所不同。我们的证据表明，未来补充和替代医学研究必须区分使用和使用频率，以便更好地理解促成补充和替代医学使用起始和持续的潜在因素。
