Immediate and Ionq-term career goals: Immediate goals are: 1) develop knowledge and research skills necessary to study the economic, sociological, psychological, and clinical determinants and outcomes of utilization of CAM services; 2) determine the relationship between the utilization of chiropractic and acupuncture services, and utilization of other health care services, for episodic recurrent back pain; 3) estimate effect of chiropractic/acupuncture utilization on costs of care, disability, and quality of life for episodic recurrent back pain; and 4) refine methods to construct clinically relevant episodes-of-care for recurrent back pain, from administrative claims data. Long-term goals are to 1) apply this knowledge to test hypotheses about inter-relationships between utilization of various CAM services, utilization of other health services, the costs, quality, outcomes, disability and disability costs, for various health conditions; 2) meaningfully contribute to our understanding of long-term conditions characterized by episodic acute recurrences; 3) contribute to developing comprehensive, multidisciplinary, and scientifically rigorous approaches to research significant clinical and public health questions; and 4) contribute to improving the quality of the research literature to better inform consumer, clinical, and health policy decision-making. ? Research career development plan: The plan includes: 1) didactic training in the science and methods of health services research and policy, with focused training in health economics and econometric modeling; 2) supervised secondary analysis of public-use national survey data to model the relationships between chiropractic and acupuncture utilization, other health services utilization, costs of care, disability, and quality of life, for episodic recurrent back pain; 3) supervised secondary analysis of administrative claims data to refine methods for constructing clinically relevant episodes-of-care for episodic recurrent back pain; and 4) development of independent investigator-initiated grant proposals. ? Research project: The proposed project will use 2-year longitudinal data from the Medical Expenditures ? Panel Survey (MEPS) to describe the patterns of utilization of chiropractic, acupuncture, and other health services for episodic recurrent back pain, and to estimate the influence of economic and sociological determinants on that utilization. This study will advance knowledge by identifying predetermining factors for CAM utilization, and will enhance our understanding of contextual and behavioral factors related to episodic recurrent conditions. Findings from these analyses, with the results of studies estimating the effects of CAM utilization on costs of care, disability, and quality of life, will be used to design follow-up projects to study interrelationships between economic, psychosocial, and clinical determinants and outcomes of CAM use. ? ?
