Eviction, Healthcare Utilization, and Disenrollment Among New York City Medicaid Patients
Eviction, Healthcare Utilization, and Disenrollment Among New York City Medicaid Patients
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DOI：
10.1016/j.amepre.2021.07.018
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发表时间：
2022-01-07
影响因子：
5.5
通讯作者：
Glied, Sherry A.
中科院分区：
文献类型：
--
作者：
Schwartz, Gabriel L.;Feldman, Justin M.;Glied, Sherry A.
简介：虽然越来越多的证据将住宅驱逐与健康联系起来，但很少有工作研究驱逐与医疗保健利用或获得之间的联系。在这项研究中，驱逐记录与医疗补助索赔估计驱逐和医疗保健利用率之间的短期关联，以及医疗补助disenrollment.Methods：纽约市驱逐记录从2017年被链接到纽约州医疗补助索赔，1,300驱逐患者匹配到261,855非驱逐患者与类似的过去的医疗保健利用率，人口统计学和社区。结果包括6个月随访期间患者的急诊和门诊就诊次数、医疗保健支出、医疗补助计划取消和药物处方填写。粗化精确匹配用于加强观测数据中的因果推断。然后拟合加权广义线性模型，包括删失权重。结果：驱逐与失去医疗补助覆盖范围的几率增加63%相关（95%CI =1.38，1.92，p
Introduction: Although growing evidence links residential evictions to health, little work has examined connections between eviction and healthcare utilization or access. In this study, eviction records are linked to Medicaid claims to estimate short-term associations between eviction and healthcare utilization, as well as Medicaid disenrollment.Methods: New York City eviction records from 2017 were linked to New York State Medicaid claims, with 1,300 evicted patients matched to 261,855 non-evicted patients with similar past healthcare utilization, demographics, and neighborhoods. Outcomes included patients' number of acute and ambulatory care visits, healthcare spending, Medicaid disenrollment, and pharmaceutical prescription fills during 6 months of follow-up. Coarsened exact matching was used to strengthen causal inference in observational data. Weighted generalized linear models were then fit, including censoring weights. Analyses were conducted in 2019-2021.Results: Eviction was associated with 63% higher odds of losing Medicaid coverage (95% CI=1.38, 1.92, p