title: Does Acupuncture Treatment Affect Utilization of Other Hospital Services at an Urban Safety-Net Hospital?
abstract: BACKGROUND
  Little is known regarding the interaction between acupuncture and biomedical healthcare among vulnerable patient populations. In particular, the association between acupuncture and total cost of healthcare has not been characterized.
  
  
  METHODS
  Total hospital system visits and associated charges were retrospectively reviewed among patients who received acupuncture at a large safety-net hospital system from 2007 to 2014. Inclusion criteria were Medicare or Medicaid insurance coverage, older than age 18 years, and one or more on-site acupuncture appointments. Patients were stratified into five groups based on the number of acupuncture visits: 1-3, 4-6, 7-9, 10-12, or 13-15 treatments. The total number of biomedical hospital visits and total associated charges were compared 6 months before and 6 months after initiation of acupuncture.
  
  
  RESULTS
  A total of 329 patients met our inclusion criteria. Although not statistically significant, there appeared to be an association between acupuncture treatment and a decrease in total hospital charges. The group receiving 1-3 acupuncture treatments showed a per-patient average increase in total charges in the 6-month period after acupuncture ($1771.34; p = 0.38). The patients who received 7-9 treatments showed the largest average decrease in total charges ($8967.24; p = 0.17).
  
  
  CONCLUSIONS
  This study shows a previously unreported aggregate relationship between number of treatments and total healthcare charges in a single urban safety-net hospital. Given the sample size available and the heterogeneity of the patient population, no statistically significant associations could be established between initiation of acupuncture treatment and charges. However, some suggestive patterns were observed. Further prospective studies with a matched-group control are warranted to further explore this relationship. Additional study across wider locations is warranted to best guide practitioners and hospitals in designing efficacious, high-value integrative medicine programs.
authors.affiliation: 1 Department of Family Medicine, Boston University School of Medicine , Boston, MA.
authors.forename: Ellen
authors.initials: E
authors.lastname: Silver Highfield
authors.affiliation: 2 Harvard Medical School , Boston, MA.
authors.forename: Mckenna
authors.initials: M
authors.lastname: Longacre
authors.affiliation: 3 Department of Health Policy and Management, Boston University School of Public Health , Boston, MA.
authors.forename: Yiing-Harn
authors.initials: YH
authors.lastname: Chuang
authors.affiliation: 3 Department of Health Policy and Management, Boston University School of Public Health , Boston, MA.|4 Center for Healthcare Organization and Implementation Research , Veterans Affairs Boston Healthcare System, Boston, MA.
authors.forename: James F
authors.initials: JF
authors.lastname: Burgess
mesh_terms: D015670:Acupuncture Therapy / Q000706:statistics & numerical data*; D001900:Boston / Q000453:epidemiology; D005260:Female; D017722:Hospital Charges; D006801:Humans; D008297:Male; D008484:Medicaid; D006278:Medicare; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D064876:Safety-net Providers; D014481:United States