Purpose: Effective utilization of complementary and alternative medicine (CAM) for management of chronic conditions has been steadily increasing over the past decade. Access to provider-based CAM services such as chiropractic is determined, in part, by healthcare coverage. Chiropractic care is covered by Medicaid although the coverage may be limited based upon individual state regulations. The purpose of this study was to evaluate patterns of chiropractic and other healthcare use in the U.S by Medicaid recipients with arthritis, the number one chronic musculoskeletal condition and the leading cause of disability in the U.S.
Methods: Weighted proportions from a nationally representative longitudinal cohort from Panel 13 (n = 18,287) of the Medical Expenditure Panel Survey spanning 2008-2009 were selected for this study to represent healthcare coverage, health status, and healthcare utilization among individuals with arthritis. The population was stratified by self-report physician-diagnosed arthritis, and healthcare coverage status. Chi-square tests were used to compare differences among healthcare coverage and arthritis status to demographics, health status, and healthcare utilization.
Results: Medicaid recipients reported the least utilization of chiropractic services compared to the privately insured and the uninsured (P < .01). More Medicaid recipients utilized office-based physician visits, filled prescription drugs, and reported poorer perceived general and mental health than the privately insured (P < .01).
Conclusion: Chiropractors need to be aware of the demographics of individuals with chronic conditions receiving Medicaid who may potentially benefit from their services and continue efforts at increasing availability of their services to vulnerable groups through healthcare reform.
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