The impact of the Affordable Care Act's medicaid expansion on patients admitted for burns : An analysis of national data
Copyright © 2021 Elsevier Ltd and ISBI. All rights reserved..
INTRODUCTION: The first states began implementing the Medicaid expansion provisions of the Patient Protection and Affordable Care Act (ACA) in 2014. Studies have yet to address its impact on burn patients.
METHODS: Burn patients in geographic regions that expanded Medicaid coverage were compared to patients in regions that did not expand Medicaid before and after implementation of the ACA using bivariate statistics and a difference-in-differences model. A multivariable logistic regression was used to identify factors associated with having Medicaid insurance. The primary outcome of this study was the rate of Medicaid insurance.
RESULTS: Of 25,331 discharges, we found greater increases in Medicaid coverage after the ACA in the Medicaid expander regions (23.4-40.2%) compared to the non-expander regions (18.5-20.1%). The difference-in-differences estimate between the expander and non-expander regions was 0.15 (95% CI: 0.11-0.18, p < 0.001). Patients admitted in expander regions were more likely to be insured by Medicaid (OR 1.57 [95%CI 1.21-2.05]), as were patients of Black race (OR 1.25 [95%CI 1.19-1.32), Hispanic ethnicity (OR 1.29 [95%CI 1.14-1.46]), and female sex (OR 1.59 [95%CI 1.11-2.27]). We also found a significant interaction between time period (pre-ACA/post-ACA) and expander region location (OR 2.10 [95%CI 1.67-2.62]).
CONCLUSIONS: The Medicaid expansion provision of the ACA led to increased Medicaid coverage among burn patients which was significantly higher in areas with widespread implementation of the expansion.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2022 |
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| Erschienen: |
2022 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:48 |
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| Enthalten in: |
Burns : journal of the International Society for Burn Injuries - 48(2022), 6 vom: 01. Sept., Seite 1340-1346 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Dalton, Michael K [VerfasserIn] |
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| Links: |
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| Themen: |
Affordable Care Act |
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| Anmerkungen: |
Date Completed 08.09.2022 Date Revised 27.12.2022 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1016/j.burns.2021.10.018 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM334398770 |
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| 100 | 1 | |a Dalton, Michael K |e verfasserin |4 aut | |
| 245 | 1 | 4 | |a The impact of the Affordable Care Act's medicaid expansion on patients admitted for burns |b An analysis of national data |
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| 500 | |a Date Revised 27.12.2022 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2021 Elsevier Ltd and ISBI. All rights reserved. | ||
| 520 | |a INTRODUCTION: The first states began implementing the Medicaid expansion provisions of the Patient Protection and Affordable Care Act (ACA) in 2014. Studies have yet to address its impact on burn patients | ||
| 520 | |a METHODS: Burn patients in geographic regions that expanded Medicaid coverage were compared to patients in regions that did not expand Medicaid before and after implementation of the ACA using bivariate statistics and a difference-in-differences model. A multivariable logistic regression was used to identify factors associated with having Medicaid insurance. The primary outcome of this study was the rate of Medicaid insurance | ||
| 520 | |a RESULTS: Of 25,331 discharges, we found greater increases in Medicaid coverage after the ACA in the Medicaid expander regions (23.4-40.2%) compared to the non-expander regions (18.5-20.1%). The difference-in-differences estimate between the expander and non-expander regions was 0.15 (95% CI: 0.11-0.18, p < 0.001). Patients admitted in expander regions were more likely to be insured by Medicaid (OR 1.57 [95%CI 1.21-2.05]), as were patients of Black race (OR 1.25 [95%CI 1.19-1.32), Hispanic ethnicity (OR 1.29 [95%CI 1.14-1.46]), and female sex (OR 1.59 [95%CI 1.11-2.27]). We also found a significant interaction between time period (pre-ACA/post-ACA) and expander region location (OR 2.10 [95%CI 1.67-2.62]) | ||
| 520 | |a CONCLUSIONS: The Medicaid expansion provision of the ACA led to increased Medicaid coverage among burn patients which was significantly higher in areas with widespread implementation of the expansion | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Affordable Care Act | |
| 650 | 4 | |a Burns | |
| 650 | 4 | |a Medicaid | |
| 650 | 4 | |a Medicaid expansion | |
| 700 | 1 | |a Riviello, Robert |e verfasserin |4 aut | |
| 700 | 1 | |a Kubasiak, John C |e verfasserin |4 aut | |
| 700 | 1 | |a Sokas, Claire M |e verfasserin |4 aut | |
| 700 | 1 | |a Osman, Samia Y |e verfasserin |4 aut | |
| 700 | 1 | |a Jin, Ginger |e verfasserin |4 aut | |
| 700 | 1 | |a Nitzschke, Stephanie L |e verfasserin |4 aut | |
| 700 | 1 | |a Ortega, Gezzer |e verfasserin |4 aut | |
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