Medicaid expansion associated with no change in emergency department use across racial and ethnic groups.
Medicaid expansion associated with no change in emergency department use across racial and ethnic groups.
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医疗补助的扩大与不同种族和族裔群体的急诊室使用情况没有变化相关。
DOI：
10.1111/1475-6773.14171
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发表时间：
2023
影响因子：
3.4
通讯作者：
Cole,MeganB
中科院分区：
文献类型：
--
作者：
Hanchate,AmreshD;Strackman,BradenW;Lin,Mengyun;Paasche-Orlow,MichaelK;Lasser,KarenE;Cole,MeganB
目的 估计西班牙裔、黑人和白人成年人中与医疗补助扩张相关的急诊科 (ED) 就诊率、急诊就诊的住院比例以及急诊就诊量的变化。数据收集/提取方法对于没有保险或医疗补助覆盖的 26-64 岁成年人口，我们获得了 2010-2018 年九个扩张州和五个非扩张州的人口普查人口和急诊就诊次数。主要成果和措施主要结局是每 100 名成年人每年急诊科就诊次数（“急诊科率”）。次要结局是导致住院的急诊就诊次数、所有急诊就诊的总数（“数量”）、导致出院的急诊就诊（“治疗后出院”）和导致住院的急诊就诊（“转入住院患者”），以及享受医疗补助的研究人群比例（“医疗补助份额”）。主要调查结果 2013 年，黑人、西班牙裔和白人成年人的急诊就诊率分别为 92.6、34.4 和 59.2。在扩张后的五年里，扩张与所有三组的 ED 率没有变化相关。我们发现，扩张与急诊就诊的住院比例以及所有急诊就诊、治疗和出院急诊就诊以及转院急诊就诊的数量没有变化相关。这一扩张与西班牙裔成年人的医疗补助比例每年增加 11.7%（95% CI，2.7%–21.2%）相关，但黑人成年人中没有显着变化（3.8%；95% CI，-0.04% 至 7.7%）。 结论 ACA 医疗补助扩张与黑人、西班牙裔和白人成年人的急诊就诊率没有变化有关。扩大医疗补助资格可能不会改变急诊室的使用，包括黑人和西班牙裔亚群体。
ObjectiveTo estimate changes in the emergency department (ED) visit rate, hospitalization share of ED visits, and ED visit volumes associated with Medicaid expansion among Hispanic, Black, and White adults.Data Collection/Extraction MethodsFor the population of adults aged 26–64 with no insurance or Medicaid coverage, we obtained census population and ED visit counts during 2010–2018 in nine expansion and five nonexpansion states.Main Outcomes and MeasuresThe primary outcome was the annual number of ED visits per 100 adults (“ED rate”). The secondary outcomes were the share of ED visits leading to hospitalization, total number (“volumes”) of all ED visits, ED visits leading to discharge (“treat‐and‐release”) and ED visits leading to hospitalization (“transfer‐to‐inpatient”), and the share of the study population with Medicaid (“Medicaid share”).Study DesignAn event‐study difference in differences design that contrasts pre‐ versus post‐expansion changes in outcomes in Medicaid expansion and nonexpansion states.Principal FindingsIn 2013, the ED rate was 92.6, 34.4, and 59.2 ED visits among Black, Hispanic, and White adults, respectively. The expansion was associated with no change in ED rate in all three groups in each of the five post‐expansion years. We found that expansion was associated with no change in the hospitalization share of ED visits and the volume of all ED visits, treat‐and‐release ED visits, and transfer‐to‐inpatient ED visits. The expansion was associated with an 11.7% annual increase (95% CI, 2.7%–21.2%) in the Medicaid share of Hispanic adults, but no significant change among Black adults (3.8%; 95% CI, −0.04% to 7.7%).ConclusionACA Medicaid expansion was associated with no changes in the rate of ED visits among Black, Hispanic, and White adults. Expanding Medicaid eligibility may not change ED use, including among Black and Hispanic subgroups.
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DOI：
10.1016/0169-6009(90)90061-j
发表时间：
1990-11-01
期刊：
BONE AND MINERAL
影响因子：
--
作者：
KIMMEL, DB;RECKER, RR;ALOIA, JF
通讯作者：
ALOIA, JF
骨质疏松症和骨软化症的骨动力学
DOI：
--
发表时间：
1966
期刊：
影响因子：
--
作者：
H. Frost
通讯作者：
H. Frost
DOI：
10.1002/aja.1000930306
发表时间：
1953
期刊：
The American journal of anatomy
影响因子：
--
作者：
E. B. Ruth
通讯作者：
E. B. Ruth
抑制固定猴子长骨中的皮质骨和小梁骨形成。
影响因子：
4.2
作者：
T. Wronski;E. Morey
通讯作者：
E. Morey
大鼠停药后，前列腺素 E2 对骨的合成代谢作用部分丧失。
影响因子：
4.1
作者：
Ke,HZ;Li,XJ;Jee,WS
通讯作者：
Jee,WS