AHA’s survey finds that nearly a fifth of hospitals now offer complementary and alternative medicine.
 |
| Sita Ananth |
Over the last decade my colleagues and I have been watching the steady increase in the number of hospitals that report they offer complementary and alternative medicine (CAM). As more Americans demand treatments outside of traditional health services, hospitals will continue to respond to that demand. In fact, according to the American Hospital Association’s Annual Survey of Hospitals, the number of hospitals offering CAM services has more than doubled, from 7.9 percent in 1998 to 19.8 percent in 2006.
To understand this phenomenon better, Health Forum conducted its third biannual Complementary and Alternative Medicine Survey of Hospitals to garner in-depth information about the CAM programs and services being offered in U.S. hospitals. The survey was divided into four major areas of inquiry:
The survey is intended to help inform hospitals, vendors, communities, patients and others of the CAM services hospitals in their communities offer or plan to offer.
Survey Results
The 2007 CAM hospital survey, a 44-question instrument, was mailed to 6,347 hospitals in November 2007. A total of 748 responses were received, for a response rate of 12 percent. Of these, 280 hospitals (37 percent) stated that they offer CAM services. The following are some highlights of the findings and some commentary on the trends; percentages are based on the 280 respondents that offer CAM services.
General institutional profile: As we found in 2003 and 2005, the hospitals most likely to offer CAM services are urban hospitals (72 percent). A typical hospital offering CAM is in the Eastern or Midwestern United States and maintains between 100 and 300 beds.
Types of services and location: The majority of all services are offered on an outpatient basis, with massage therapy (54 percent), acupuncture (35 percent) and relaxation training (27 percent) among the most popular. On an inpatient basis, the top modalities offered are pet therapy (46 percent), massage therapy (40 percent) and music/art therapy (30 percent). Key reasons hospitals gave for offering CAM services were patient demand (84 percent), clinical effectiveness (67 percent) and reflecting organizational mission (57 percent). This seems to controvert the theory that hospitals rely only on procedures or services that have a proven evidence base. Many hospitals include community health and “whole person” health in their mission statements, making CAM services a natural fit.
Finances and reimbursement: Eighty-six percent stated that their startup costs were below $200,000, indicating that these programs can be started with relatively little money. Forty-two percent characterized their programs as breaking even. Interestingly, of the programs not breaking even, 64 percent stated that they never expected to break even, indicating the programs were likely viewed as part of the organizational mission or as a loss leader. Patient self-pay (71 percent) continues to be the predominant mode of payment for CAM services, which unfortunately forms a barrier to access.
Planning and staffing: Strategic and business planning for CAM efforts are sorely lacking in hospitals. Support for the CAM programs came from hospital administrators, who were mostly responsible for launching (53 percent) and continuing to champion the organization’s CAM efforts (55 percent). Such support bodes well for the sustainability of these programs. However, only 30 percent of CAM programs had their own strategic plan, and less than half of hospitals reported having CAM included in their hospital strategic plan. Seventy-seven percent said patients were referred by a physician, a good indicator that physicians are accepting the role of CAM services in caring for patients.
Evaluation and research: Patient satisfaction (86 percent) seems to be the metric of choice in the evaluation of CAM services, followed by volume (55 percent). Outcomes research is definitely a weakness of CAM efforts: Only 42 percent are conducting any kind of outcomes assessments. The greatest challenges faced by hospitals in implementing programs are budgetary constraints (67 percent) and physician resistance (46 percent). With regard to the future, of those hospitals that are not currently offering any CAM services, 13 percent stated there were plans to do so. Six percent of survey respondents had previously offered CAM programs but discontinued them due to general cuts in nonessential programs (59 percent), poor financial performance (40 percent) or inability to break even (also 40 percent).
For the complete report and data file, please visit www.healthforumonlinestore.com and click on “Data Products” in the left-hand navigation bar.
Sita Ananth, M.H.A., is director of knowledge services, Optimal Healing Environments, for the Samueli Institute, a nonprofit medical research organization in Alexandria, Va. She is also the author of this study and a regular contributor to H&HN Weekly.
Hospitals & Health Networks welcomes your comment on this article. E-mail your comments to hhn@healthforum.com, fax them to H&HN Editor at (312) 422-4500, or mail them to Editor, Hospitals & Health Networks, Health Forum, One North Franklin, Chicago, IL 60606.
