Journal article
Eviction, Healthcare Utilization, and Disenrollment Among New York City Medicaid Patients
American journal of preventive medicine, Vol.62(2), pp.157-164
01 Feb 2022
PMID: 35000688
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
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<0.001), fewer pharmaceutical prescription fills (incidence rate ratio=0.68, 95% CI=0.52, 0.88, p=0.004), and lower odds of generating any healthcare spending (OR=0.72, 95% CI=0.61, 0.85, p<0.001). However, among patients who generated any spending, average spending was 20% higher for those evicted (95% CI=1.03, 1.40, p=0.017), such that evicted patients generated more spending on balance. Marginally significant estimates suggested associations with increased acute, and decreased ambulatory, care visits.
Conclusions: Results suggest that eviction drives increased healthcare spending while disrupting healthcare access. Given previous research that Medicaid expansion lowered eviction rates, eviction and Medicaid disenrollment may operate cyclically, accumulating disadvantage. Preventing evictions may improve access to care and lower Medicaid costs.
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Details
- Title
- Eviction, Healthcare Utilization, and Disenrollment Among New York City Medicaid Patients
- Creators
- Gabriel L. Schwartz - University of California, San FranciscoJustin M. Feldman - Harvard UniversityScarlett S. Wang - New York UniversitySherry A. Glied - New York University
- Publication Details
- American journal of preventive medicine, Vol.62(2), pp.157-164
- Publisher
- Elsevier
- Number of pages
- 8
- Grant note
- New York University Health Evaluation and Analytics Lab Robert Wood Johnson Foundation's Policies for Action program; Robert Wood Johnson Foundation (RWJF)
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Health Management and Policy; Urban Health Collaborative
- Identifiers
- 991021871450904721
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Public, Environmental & Occupational Health