OBJECTIVE: To assess the effects of continuity of insurance coverage on treatment of ambulatory-care sensitive conditions (ACSC). STUDY POPULATION: 42,382 children enrolled in ALL Kids (Alabama Children's Health Insurance Program) for 3 or more years. METHODS: We model annual hospitalizations and ED visits for six ACSCs identified by the AHRQ - bacterial pneumonia, dehydration, perforated appendix, urinary tract infection, gastroenteritis, and severe ear, nose and throat infection. RESULTS: In unadjusted models, we find lower risk of ACSC hospitalizations and ED visits in the second and third years of continuous enrollment. Risk of hospitalization in year 3 was significantly lower for pneumonia (OR 0.608, 95% CI: 0.421-0.878) and gastroenteritis (OR 0.549, 95% CI: 0.404-0.746). These beneficial effects of duration of coverage disappear after controlling for age, year and other enrollee characteristics. CONCLUSIONS: Hospitalizations and ED visits for ACSCs are rare and do not decrease with additional years of coverage.
OBJECTIVE: To assess the effects of continuity of insurance coverage on treatment of ambulatory-care sensitive conditions (ACSC). STUDY POPULATION: 42,382 children enrolled in ALL Kids (Alabama Children's Health Insurance Program) for 3 or more years. METHODS: We model annual hospitalizations and ED visits for six ACSCs identified by the AHRQ - bacterial pneumonia, dehydration, perforated appendix, urinary tract infection, gastroenteritis, and severe ear, nose and throat infection. RESULTS: In unadjusted models, we find lower risk of ACSC hospitalizations and ED visits in the second and third years of continuous enrollment. Risk of hospitalization in year 3 was significantly lower for pneumonia (OR 0.608, 95% CI: 0.421-0.878) and gastroenteritis (OR 0.549, 95% CI: 0.404-0.746). These beneficial effects of duration of coverage disappear after controlling for age, year and other enrollee characteristics. CONCLUSIONS: Hospitalizations and ED visits for ACSCs are rare and do not decrease with additional years of coverage.
Authors: Michael A Morrisey; Justin Blackburn; Bisakha Sen; David Becker; Meredith L Kilgore; Cathy Caldwell; Nir Menachemi Journal: Medicare Medicaid Res Rev Date: 2012-03-08