Phil B.FontanarosaMD, Deputy EditorIndividualAuthorMargaret A.WinkerMD, Deputy EditorIndividualAuthorStephen J.LurieMD, PhD, Fishbein FellowIndividualAuthor
In Reply: Mr Barzilai and Dr Rimm propose 2
interesting and testable hypotheses: first, that physician referrals might
be a major factor underlying the relationship between the 2 types of care,
and second, that uninsured patients might use these therapies differently
than those with health insurance do.
Table 1 shows the multivariate
analysis modeling use and quantity of physician visits as a function of unconventional
service use in 2 subgroups: patients not reporting a physician referral for
unconventional treatment and patients without insurance. In each of these
subsamples, having an unconventional visit is strongly associated with physician
visits, although the magnitude of these associations is somewhat smaller than
for the entire sample. These findings suggest that insurance status and physician
referrals may partly mediate, but are not the primary factors driving, the
association between the 2 systems of care.
Druss BG, Rosenheck RA. Environmental Health. JAMA. 2000;283(1):56-57. doi:10-1001/pubs.JAMA-ISSN-0098-7484-283-1-jbk0500