Department of Public Health and General Practice, Norwegian University of Science and Technology, Trondheim, Norway.
J Altern Complement Med. 2009 Nov;15(11):1201-7. doi: 10.1089/acm.2009.0163.
The United States and Norway are among the countries that have the highest total expenditure on health per capita and also high utilization of complementary and alternative medicine (CAM). However, these countries have fundamentally different health care systems. The aim was therefore to compare characteristics of adults who have seen a CAM practitioner during the last year in the United States and Norway.
Data from the National Health Interview Survey in the United States from 2002 and the Level of Living survey in Norway from 2002 were used. Both surveys were nationally representative household surveys of the noninstitutionalized civilian population. The data consist of 6612 individuals from Norway and 31,044 individuals from the United States.
In the United States, 7.4% of the population had seen a CAM practitioner during the last 12 months compared to 8.7% in Norway (p < 0.001 for difference). In both the United States and Norway, seeing a CAM practitioner was most strongly associated with seeing other health care practitioners and having experienced better or worse self-reported health in the last year. Being male and a daily smoker reduced the odds of seeing a CAM practitioner in both countries. In the United States, but not Norway, having higher education was strongly associated with seeing a CAM practitioner. Higher education was the variable with the biggest difference between the two countries.
This study indicates that in a country that provides health care services for all based on need regardless of personal income (Norway), the utilization of CAM practitioners is higher and less associated with use of other health care providers than a country with low government expenditure on health (the United States).
美国和挪威是人均总卫生支出最高和补充与替代医学（CAM）利用率最高的国家之一。然而，这两个国家的医疗保健系统却截然不同。因此，本研究旨在比较过去一年中曾接受过 CAM 从业者治疗的美国和挪威成年人的特征。
使用了来自美国 2002 年全国健康访谈调查和挪威 2002 年生活水平调查的数据。这两个调查都是针对非机构化平民人口的全国代表性家庭调查。数据包括来自挪威的 6612 人和来自美国的 31044 人。
在美国，有 7.4%的人口在过去 12 个月中曾接受过 CAM 从业者的治疗，而挪威为 8.7%（两国间差异具有统计学意义，p < 0.001）。在美国和挪威，接受 CAM 从业者治疗与接受其他医疗从业者治疗以及过去一年中自我报告的健康状况更好或更差密切相关。男性和每日吸烟者在两个国家中均降低了接受 CAM 从业者治疗的可能性。在美国，但不是在挪威，接受更高的教育程度与接受 CAM 从业者治疗密切相关。受教育程度是两国之间差异最大的变量。
本研究表明，在一个基于需求为所有人提供医疗保健服务而不考虑个人收入的国家（挪威），CAM 从业者的利用率更高，与其他医疗保健提供者的使用相关性更低，而在一个政府对卫生保健支出较低的国家（美国）则相反。
