Major health care reform in Taiwan started in 1995 with the introduction of a national health insurance (NHI) system. Unlike most health systems where most complementary or alternative medicine is not covered, Taiwan's NHI covers Traditional Chinese Medicine (TCM). Included in TCM are some forms of Complementary and Alternative Medicine (CAM) such as acupuncture, massage, osteopathic manipulation, or chiropractic medicine, though some still pay out of their own pocket for these services provided by non-NHI contract providers. While previous studies on utilization of health care have concentrated on western medicine, little attention has been paid to the utilization of CAM under the NHI. This study analyzes the prevalence, cost, and patterns of CAM use and investigates the characteristics of CAM users of services covered and not covered by the NHI. We use the 2001 National Health Interview Survey and National Health Insurance claims data to analyze the utilization of covered TCM and non-covered CAM under the NHI. This study represents the first attempt to characterize utilization of CAM from nationwide perspective and compare use of non-covered CAM with the use of TCM covered by the NHI. Descriptive statistics are used to characterize utilization of CAM including the number of visits, expenditures, as well as types of CAM used. Chi-square and t statistics will be used to test the significance of CAM use among different groups. Multiple logistic regression model will be used to investigate the determinants of use of CAM under the universal coverage system.
