Hospitals AHA and Samueli Institute survey finds 42% of hospitals offer CAM servicesOn September 7, 2011, the American Hospital Association and Samueli Institute announced the result of their long awaited 2010 survey on complementary and alternative medicine (CAM) use in
On September 7, 2011, the American Hospital Association and Samueli Institute announced the result of their long-awaited 2010 survey on complementary and alternative medicine (CAM) use in hospitals. The basic finding is that more than 42 percent of responding hospitals indicated they offer one or more CAM therapies. This up from 37 percent in 2007 and 26.5% in 2005. The joint release is here. The full report is here. [Due to a deadline, this brief is based only on the release.]
The survey was mailed in to 5,858 hospitals in March of 2010. Results are based on 714 responses (12%), a similar response rate as 2007. Nancy Foster, vice president for quality and patient safety at the AHA states:
“The rise of complementary and alternative medicine reflects the continued effort on the part of hospitals and caregivers to broaden the vital services they provide to patients and communities. Hospitals have long known that what they do to treat and heal involves more than just medications and procedures. It is about using all of the art and science of medicine to restore the patient as fully as possible.”
Of the responding hospitals, 78% indicated patient demand as a rationale for inclusion. Clinical effectiveness, however, was key for 74% percent of survey respondents. Sita Ananth, MHA, director of knowledge services for Samueli Institute notes:
“Today’s patients have better access to health information and are demanding more personalized care. The survey results reinforce the fact that patients want the best that both conventional and alternative medicine can offer, and hospitals are responding.”
Among the other findings:
- Majority of respondents offer wellness services for patients and staff, including nutritional counseling, smoking cessation, fitness training and pastoral care;
- Massage therapy is in the top two services provided in both outpatient and inpatient settings;
- The majority of hospitals that offered CAM were urban hospitals (72 percent); and
- 75% cited budgetary constraints as the biggest obstacle for implementation of CAM programs.
The release states that “CAM is not based solely on traditional western allopathic medical teachings, and can include acupuncture, chiropractic, homeopathy, diet and lifestyle changes, herbal medicine, massage therapy and more.” The release continues add: “CAM services also reflect hospitals’ desire to treat the whole person-body, mind and spirit.” The full report is available here.
Comment: The most significant data point here is that 74% say that “clinical effectiveness” is a top reason for inclusion. This growth took place in a down economy and despite the lack of good payment models for CAM. These findings will be interesting to view after new incentive structures that might support CAM inclusion kick in with the growth of accountable care organizations (ACOs).
The authors of this study entitled “Personal Use of Complementary and Alternative Medicine (CAM) by U.S. Healthcare Workers” conclude: “Personal CAM use by healthcare workers may influence the integration of CAM with conventional healthcare delivery.” The “healthcare workers” were described as those “employed in hospitals and ambulatory care settings.” The team of researchers from Allina Hospitals & Clinics, the Penny George Institute and the University of Minnesota announced findings on August 19, 2011. Core finding: 76% of healthcare workers used CAM in the previous year. This compared to 63% in the general population. The top conditions for which CAM was sought by healthcare workers reflect the general population as captured in the Consumer health survey: back pain, neck pain and joint pain. The analysis was based on the CDC’s 2007 National Health Interview Survey.
Co-author Lori Knutson, RN, BSN, HN-BC, shared some of the flavor of the rapid media uptake. “The study findings went out on the AP news line on Friday morning” the 19th, she wrote in an email. Knutson adds: “By Friday night I had done interviews with the New York Times, CBS, MSNBC, and NBC.” Scores of stories have continued to roll out since. The authors conclude that these finding may have significant ramifications for the movement toward “integrative care.” They conclude: “Personal use of CAM by healthcare workers may be a principal determinant in the movement toward ‘integrative care’ – the mainstreaming of CAM with allopathic medicine.”
Comment: When I shared there findings with Colleague Sean Sullivan, JD, co-founder of the employer-based Institute for Health and Productivity Management, he quipped: “This is like public school teachers who send their kids to private schools.” My guess is that the authors are right in their conclusion. Personal practices and professional services will move toward better alignment. These new data will empower these advocates further.
Consumer Reports published a 15 page article in July entitled Alternative Treatments: More than 45,000 readers tell us what helped. Use was found to be high. The media re-published findings widely. Examples were KABC Los Angeles, the Hartford Current, Seattle’s KOMO News (“Effective Alternative Therapies”) and the Cleveland Plain Dealer. The latter article’s headline concluded that these treatments are “real competition for prescriptions,” underscoring their “alternative” nature. The article breaks down patient use of diverse CAM therapies and providers for 11 common conditions. (See left side of page here for links to individual condition reports.) Each condition-specific account has 3 columns: type of treatment, the percent of consumer who used, and a ranking of whether the modality or practitioner “helped a lot.” Data are also presented on perspectives relative to OTCs and prescription drugs for the same condition.
A chief finding was that use remains high even though consumers tend to experience prescription medications as more frequently “helping a lot.” A significant exception was in the area of back pain and neck pain. In each condition, chiropractic is viewed as “helping a lot” by nearly two-thirds of users. This compares with just about half of prescription drug users. Deep tissue massage and yoga also fare particularly well with some conditions. The report concludes with a User’s Guide to Hand-on Therapies. The article in the Integrator culls information about therapies ranked highest in “helped a lot.”
Comment: Notably, treatments related to CAM providers and CAM disciplines rather than CAM self-care receive the highest marks. The report offers a very low-end type of comparative effectiveness research. Interesting data, from a lot of consumers.