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Acupuncture ‘dose’ (number of treatments) and insurance benefits in the USA
  1. Natalie A Schwehr1,
  2. Nathan D Shippee1,
  3. Pamela Jo Johnson2
  1. 1 Division of Health Policy and Management School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA
  2. 2 Epidemiology, University of Minnesota, Minneapolis, Minnesota, USA
  1. Correspondence to Natalie A Schwehr, Division of Health Policy and Management, School of Public Health, University of Minnesota, 2221 University Ave SE #345, Minneapolis, MN 55414, USA; schwe425{at}


Background An adequate treatment dose, including a sufficient number of acupuncture treatments, is important for the clinical effectiveness of acupuncture treatment for common conditions.

Objective To examine the characteristics of US adults who used a full course of acupuncture (≥6 treatments), a short course (1–5 treatments) or no acupuncture, including use of insurance benefits for acupuncture among users.

Methods We used population-based survey data from the 2012 National Health Interview Survey (NHIS), the most current nationally representative data including use of acupuncture. We described subgroups of acupuncture users and used logistic regression to estimate the odds of past year acupuncture use versus non-use and completion of a full treatment course versus a short course. Covariates included demographic factors and health status. Analyses used strata, weights and clustering to account for the complex sample design.

Results Among acupuncture users, 38% completed a full course. Acupuncture use was low (1.5%), but odds were higher among women and those with greater education and less poverty. Those who used acupuncture insurance benefits and who had greater education were more likely to receive a full treatment course. Insurance benefits attenuated disparities in use by sex and race/ethnicity.

Conclusion Nationally, most people who use acupuncture do not receive a full treatment course. Considering evidence of effectiveness, low risk and relatively low cost of delivery, acupuncture could play a larger role in non-pharmaceutical treatment of common conditions such as pain. Policymakers should consider that, without insurance benefits for acupuncture, people are less likely to complete a full treatment course, which may contribute to disparities in use and health outcomes.

  • acupuncture
  • epidemiology
  • public health

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  • Contributors NAS initiated the project, wrote the statistical analysis plan, cleaned and analysed the data, and drafted and revised the paper. She is guarantor. PJJ and NDS wrote the statistical analysis plan and revised the draft paper. All authors read and approved the final version accepted for publication.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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