Journal article
Medicaid Expansion Under the Affordable Care Act and Pediatric Trauma Patient Insurance Coverage
The Journal of surgical research, v 276, pp 10-17
Aug 2022
PMID: 35325680
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Uninsured pediatric trauma patients are at increased risk of poor outcomes. The impact of the Patient Protection and Affordable Care Act (ACA) on pediatric trauma patients has not been studied. We hypothesized that the expansion of Medicaid coverage under the ACA was associated with increased insurance coverage and improved outcomes.
Retrospective review of patients <18 y old presenting to a level 1 pediatric trauma center 2009-2019. An interrupted time series analysis was performed to assess the impact of Medicaid expansion under the ACA in January 2014. The primary outcome was rate of insurance coverage. Secondary outcomes included in-hospital mortality, disposition, 30-day readmission, length of stay (LOS), and intensive care unit (ICU) LOS.
A total of 5645 patients were evaluated, (pre-ACA n = 2,243, post-ACA n = 3402). Expansion of Medicaid was associated with minimal changes on insurance coverage. There a decrease in mortality (RR = 0.96, P = 0.0355) and a slight increase in disposition to a rehabilitation facility (RR = 1.02, P = 0.0341). There was no association with 30-day readmission (RR = 1.02, P = 0.3498). Similarly, expansion of Medicaid was not associated with change in LOS (estimate = −0.00, P = 0.8893). There was a slight decrease in ICU LOS (estimate = −0.03, P < 0.0001).
Medicaid expansion was associated with marginal changes in insurance coverage among pediatric trauma patients. We did not identify significant impacts on patient outcomes.
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Details
- Title
- Medicaid Expansion Under the Affordable Care Act and Pediatric Trauma Patient Insurance Coverage
- Creators
- Sarah C. Stokes - University of California, DavisKaeli J. Yamashiro - University of California, DavisGanesh Rajasekar - University of California, DavisMiriam A. Nuño - University of California, DavisEdgardo S. Salcedo - University of California, DavisAlana L. Beres - University of California, Davis
- Publication Details
- The Journal of surgical research, v 276, pp 10-17
- Publisher
- Elsevier
- Number of pages
- 8
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Surgery
- Web of Science ID
- WOS:000806762900002
- Scopus ID
- 2-s2.0-85126596458
- Other Identifier
- 991021969587004721
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- Web of Science research areas
- Surgery