The Affordable Care Act reduces emergency department use by young adults: evidence from three States.
The Affordable Care Act reduces emergency department use by young adults: evidence from three States.
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DOI：
10.1377/hlthaff.2014.0103
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发表时间：
2014-09
期刊：
影响因子：
--
通讯作者：
Goldstein BA
中科院分区：
文献类型：
--
作者：
Hernandez-Boussard T;Burns CS;Wang NE;Baker LC;Goldstein BA
《平价医疗法案》(ACA)延长了19-25岁年轻人享受医疗保险的资格。这一延期可能影响了年轻人使用急诊科(ED)护理和其他医疗服务的方式。为了测试ACA对年轻人如何使用ED服务的影响，我们使用了加利福尼亚州、佛罗里达州和纽约州2009-11年度的州行政记录，比较了ACA条款实施前后19-25岁年轻人使用ED的变化与同期26-31岁人群(对照组)的变化。在ACA条款实施后，与老年组相比，年轻组每千人的急诊就诊次数减少了2.7%-−相对变化了2.1个百分点。相对降幅最大的是女性(−3.0%)和黑人(−3.4%)。ED使用量的相对减少意味着2011年这三个州19-25岁的年轻人总共减少了60,000多次就诊。当我们比较实施ACA条款前后使用ED的概率时，我们发现与老年组相比，年轻组的降幅最小(−为0.4%)。这表明，访问次数的变化是由教育署用户访问次数的减少推动的，而不是由于访问过教育署的人数的变化。
The Affordable Care Act (ACA) extended eligibility for health insurance for young adults ages 19–25. This extension may have affected how young adults use emergency department (ED) care and other health services. To test the impact of the ACA on how young adults used ED services, we used 2009–11 state administrative records from California, Florida, and New York to compare changes in ED use in young adults ages 19–25 before and after the ACA provision was implemented with changes in the same period for people ages 26–31 (the control group). Following implementation of the ACA provision, the younger group had a decrease of 2.7 ED visits per 1,000 people compared to the older group—a relative change of −2.1 percent. The largest relative decreases were found in women (−3.0 percent) and blacks (−3.4 percent). This relative decrease in ED use implies a total reduction of more than 60,000 visits from young adults ages 19–25 across the three states in 2011. When we compared the probability of ever using the ED before and after implementation of the ACA provision, we found a minimal decrease (−0.4 percent) among the younger group compared to the older group. This suggests that the change in the number of visits was driven by fewer visits among ED users, not by changes in the number of people who ever visited the ED.
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