Association between Medicaid Expansion under the Affordable Care Act and Preemptive Listings for Kidney Transplantation
| Autor: | Suzanne M. Boyle, Meera N. Harhay, David J. Reich, Gary Xiao, Karthik Ranganna, Ryan M. McKenna, Stephen Guy, Lissa Levin Mizrahi, Michael O. Harhay, Gregory Malat |
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| Rok vydání: | 2018 |
| Předmět: |
Adult
Male Waiting Lists Epidemiology medicine.medical_treatment 030232 urology & nephrology Ethnic group Critical Care and Intensive Care Medicine Health Services Accessibility 03 medical and health sciences 0302 clinical medicine Patient Protection and Affordable Care Act medicine Health insurance Humans 030212 general & internal medicine Healthcare Disparities health care economics and organizations Kidney transplantation Dialysis Multinomial logistic regression Transplantation business.industry Medicaid Editorials Retrospective cohort study Original Articles Middle Aged medicine.disease Kidney Transplantation United States Nephrology Kidney Diseases Female business Demography |
| Zdroj: | Clinical journal of the American Society of Nephrology : CJASN. 13(7) |
| ISSN: | 1555-905X |
| Popis: | BACKGROUND AND OBJECTIVES: Before 2014, low-income individuals in the United States with non–dialysis-dependent CKD had fewer options to attain health insurance, limiting their opportunities to be preemptively wait-listed for kidney transplantation. We examined whether expanding Medicaid under the Affordable Care Act was associated with differences in the number of individuals who were pre-emptively wait-listed with Medicaid coverage. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: Using the United Network of Organ Sharing database, we performed a retrospective observational study of adults (age≥18 years) listed for kidney transplantation before dialysis dependence between January 1, 2011–December 31, 2013 (pre-Medicaid expansion) and January 1, 2014–December 31, 2016 (post-Medicaid expansion). In multinomial logistic regression models, we compared trends in insurance types used for pre-emptive wait-listing in states that did and did not expand Medicaid with a difference-in-differences approach. RESULTS: States that fully implemented Medicaid expansion on January 1, 2014 (“expansion states,” n=24 and the District of Columbia) had a 59% relative increase in Medicaid-covered pre-emptive listings from the pre-expansion to postexpansion period (from 1094 to 1737 listings), compared with an 8.8% relative increase (from 330 to 359 listings) among 19 Medicaid nonexpansion states (P |
| Databáze: | OpenAIRE |
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