The Affordable Care Act and emergency department use by low acuity patients in a US hospital
Autor: | Hassan Mouzaihem, Jaqueline Vidosh, Patrick Stone, Hisham Valiuddin, Daniel Keyes |
---|---|
Rok vydání: | 2020 |
Předmět: |
Adult
Public policy Primary care Insurance Coverage Out patients Young Adult 03 medical and health sciences 0302 clinical medicine Health care Health insurance Humans Medicine 030212 general & internal medicine Medically Uninsured business.industry Patient Protection and Affordable Care Act Health Policy 030208 emergency & critical care medicine Emergency department Middle Aged medicine.disease Hospitals United States Medical emergency Emergency Service Hospital business |
Zdroj: | Health Services Management Research. 34:128-135 |
ISSN: | 1758-1044 0951-4848 |
Popis: | Background The Affordable Care Act (ACA) is one of the biggest healthcare reforms in US history. A key issue is the ACAs effect on low acuity, potentially primary care patients. This study evaluates the effect of the ACA on low acuity patients seen in the emergency department (ED). Methods This is an age-period-cohort analysis for a community hospital ED in Michigan, from 2009 to 2015. Patients were stratified by age, year seen, emergency severity index (ESI) and insurance status. Data were compared between before and after ACA along with descriptive statistics, Chi-square and Student t-tests. The primary outcome was the change in ED usage by low acuity. Patients > 65 were used as a temporal control. Results 305,350 ED visits were analyzed. ED visits with ESI 4/5 increased from 11.9% to 14.8%. Patients 65 increased from 5.1% to 6.5%. Patients 65: uninsured rate remained the same 0.46% to 0.49%. Conclusion Low acuity ED visits increased with the ACA reform in conjunction with a more insured population. |
Databáze: | OpenAIRE |
Externí odkaz: |