Emanuel Eguia1, Timothy Classen2, Mashkoor Choudhry3, Marc Singer1, Joshua Eberhardt1. 1. Department of Surgery, Colorectal Surgery Service, Loyola University Medical Center, Maywood, Illinois, USA. 2. Quinlan School of Business, Loyola University Chicago, Chicago, IL. 3. Burn Shock Trauma Research Institute, Loyola University Chicago, Maywood, IL.
Abstract
OBJECTIVE: The goal of this study was to examine the effect of the Affordable Care Act Medicaid expansion on rates of hospitalization and surgery for diverticulitis. STUDY SETTINGS: Data were obtained from the Healthcare Cost and Utilization Project State Inpatient Databases from 2010 to 2014. STUDY DESIGN: Retrospective cohort study analyzing adult patients undergoing surgery for diverticulitis in the expansion and nonexpansion states, pre (2010-2013) and post (2014) Medicaid expansion. FINDINGS: There were a total of 159,419 patients in our cohort analysis. 75,575 (49%) in expansion states and 81,844 (51%) in non-expansion states. In multivariable Poisson regression, the rate of surgical procedures for diverticular disease increased among Medicaid patients (IRR 1.80; p<.01) whereas surgery rates in self-pay patients decreased (IRR 0.67; p<.01) in expansion states compared to non-expansion states. CONCLUSIONS: In states that expanded Medicaid coverage under the Affordable Care Act, the rate of surgery for diverticular disease in Medicaid patients increased. Therefore, legislation that increases healthcare access may increase the utilization of surgical care for diverticular disease.
OBJECTIVE: The goal of this study was to examine the effect of the Affordable Care Act Medicaid expansion on rates of hospitalization and surgery for diverticulitis. STUDY SETTINGS: Data were obtained from the Healthcare Cost and Utilization Project State Inpatient Databases from 2010 to 2014. STUDY DESIGN: Retrospective cohort study analyzing adult patients undergoing surgery for diverticulitis in the expansion and nonexpansion states, pre (2010-2013) and post (2014) Medicaid expansion. FINDINGS: There were a total of 159,419 patients in our cohort analysis. 75,575 (49%) in expansion states and 81,844 (51%) in non-expansion states. In multivariable Poisson regression, the rate of surgical procedures for diverticular disease increased among Medicaid patients (IRR 1.80; p<.01) whereas surgery rates in self-pay patients decreased (IRR 0.67; p<.01) in expansion states compared to non-expansion states. CONCLUSIONS: In states that expanded Medicaid coverage under the Affordable Care Act, the rate of surgery for diverticular disease in Medicaid patients increased. Therefore, legislation that increases healthcare access may increase the utilization of surgical care for diverticular disease.
Entities:
Keywords:
Affordable Care Act; Colorectal surgery; Medicaid expansion; diverticulitis
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