Arizona State University, Southwest Interdisciplinary Research Center, 411 N. Central Ave., Suite 720, Phoenix, AZ 85004-0693, USA.
Health Serv Res. 2012 Oct;47(5):2081-96. doi: 10.1111/j.1475-6773.2012.01406.x. Epub 2012 Mar 30.
To test the association between delays in utilization of conventional medical care and complementary and alternative medicine (CAM) utilization.
The 2007 National Health Interview Survey, a cross-sectional nationally representative study of adults aged 18 years and older.
Using zero-inflated regression models, delays in utilizing conventional care due to organizational inaccessibility are examined to determine whether delays are associated with both the decision to try CAM and the number of CAM types used.
Individuals have significantly higher odds using provider-based CAM types if they delayed seeking conventional care due to organizational inaccessibility (OR = 1.63). Individuals use significantly more types of both provider-based (IRR = 1.35) and non-provider-based (IRR = 1.49) CAM if they delayed seeking conventional care due to organizational inaccessibility.
Individuals who delay seeking conventional medical care are more likely to use CAM and use more types of CAM. The current structure of the conventional health care system may have created barriers that can make conventional health care inaccessible. Individuals who face these barriers appear to be pushed not only into trying CAM but using a greater number of CAM types, a finding not in previous research.
检验常规医疗服务利用延迟与补充和替代医学（CAM）利用之间的关联。
2007 年全国健康访谈调查，这是一项针对 18 岁及以上成年人的全国代表性横断面研究。
利用零膨胀回归模型，检验由于组织可及性差而导致的常规医疗服务利用延迟，以确定延迟是否与尝试 CAM 的决定以及使用的 CAM 类型数量有关。
如果由于组织可及性差而延迟寻求常规医疗，那么使用基于提供者的 CAM 类型的个体具有显著更高的可能性（OR=1.63）。如果由于组织可及性差而延迟寻求常规医疗，那么个体使用的基于提供者的（IRR=1.35）和非提供者的（IRR=1.49）CAM 类型显著更多。
延迟寻求常规医疗的个体更有可能使用 CAM，并且使用更多类型的 CAM。传统医疗保健系统的现有结构可能已经造成了障碍，使常规医疗服务变得不可及。面临这些障碍的个体不仅被推向尝试 CAM，而且使用更多类型的 CAM，这是之前研究中没有发现的。
