Complementary and alternative medicine: Beyond users and nonusers

Background: Studies of complementary and alternative medicine (CAM) commonly distinguish between "users" and "nonusers". Objectives: To examine the group of "users" of CAM practitioners' services, and to characterize its heterogeneity in relation to the conventional medicine system. Design: The heterogeneity of CAM users was examined with respect to three variables: user-type-CAM only or both CAM and conventional therapies, provider-type-CAM provider is a medical doctor or not, and referral-type-by a physician or self-referral. Methods: The data are drawn from two health surveys conducted among 4500 persons representing the Israeli Jewish urban population aged 45-75 in 1993 and in 2000. Results: Multivariate analyses confirm the heterogeneity of CAM users, and indicate that the variation within "users" is often larger than the variation between "users" and "nonusers". Conclusions: For a better understanding of consumers' behavior with respect to CAM use, one must go beyond the classical classification of "users" versus "nonusers". The present analysis offers three additional dimensions-user-type, provider-type, and referral-type.