ArticleBMJ (Clinical research ed.)2015
Effect of Massachusetts healthcare reform on racial and ethnic disparities in admissions to hospital for ambulatory care sensitive conditions: retrospective analysis of hospital episode statistics.
Article in BMJ (Clinical research ed.), 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 1 of them a synthesis that pooled it.
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Who cites it
18 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Social determinants of ambulatory care sensitive conditions: a qualitative meta-synthesis based on patient perspectives.Frontiers in public health · 2023Pooled it
- Diabetes Control During Massachusetts Insurance Reform.Journal of racial and ethnic health disparities · 2022Article
- Article
- The Influence of Health Insurance Stability on Racial/Ethnic Differences in Diabetes Control and Management.Ethnicity & disease · 2021Article
- Measuring Health Equity in Emergency Care Using Routinely Collected Data: A Systematic Review.Health equity · 2021Review
- Is insurance instability associated with hypertension outcomes and does this vary by race/ethnicity?BMC health services research · 2020Observational
- Analysis of racial differences in hospital stays in the presence of geographic confounding.Spatial and spatio-temporal epidemiology · 2019Article
- Evaluating the impact of health policies: using a difference-in-differences approach.International journal of public health · 2019Article
- Lifetime Consequences of Early-Life and Midlife Access to Health Insurance: A Review.Medical care research and review : MCRR · 2018Review
- Disparities in Potentially Preventable Hospitalizations: Near-National Estimates for Hispanics.Health services research · 2018Article
- Medicaid Managed Care in Florida and Racial and Ethnic Disparities in Preventable Emergency Department Visits.Medical care · 2018Article
- Massachusetts Health Reform's Effect on Hospitalizations with Substance Use Disorder-Related Diagnoses.Health services research · 2018Article
- Impact of Massachusetts Health Reform on Inpatient Care Use: Was the Safety-Net Experience Different Than in the Non-Safety-Net?Health services research · 2017Article
- Affordability of and Access to Information About Health Insurance Among Immigrant and Non-immigrant Residents After Massachusetts Health Reform.Journal of immigrant and minority health · 2017Article
- Evaluating the Health Impact of Large-Scale Public Policy Changes: Classical and Novel Approaches.Annual review of public health · 2017Review
- The Great American Recession and forgone healthcare: Do widened disparities between African-Americans and Whites remain?PloS one · 2017Article
- Article
- Have Racial Disparities in Ambulatory Care Sensitive Admissions Abated Over Time?Medical care · 2015Article
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7 authors.
Funding
Abstract
objectivesTo examine the impact of Massachusetts healthcare reform on changes in rates of admission to hospital for ambulatory care sensitive conditions (ACSCs), which are potentially preventable with good access to outpatient medical care, and racial and ethnic disparities in such rates, using complete inpatient discharge data (hospital episode statistics) from Massachusetts and three control states.
designDifference in differences analysis to identify the change, overall and according to race/ethnicity, adjusted for secular changes unrelated to reform.
settingHospitals in Massachusetts, New York, New Jersey, and Pennsylvania, United States.
participantsAdults aged 18-64 (those most likely to have been affected by the reform) admitted for any of 12 ACSCs in the 21 months before and after the period during which reform was implemented (July 2006 to December 2007).
main outcome measuresAdmission rates for a composite of all 12 ACSCs, and subgroup composites of acute and chronic ACSCs.
resultsAfter adjustment for potential confounders, including age, race and ethnicity, sex, and county income, unemployment rate and physician supply, we found no evidence of a change in the admission rate for overall composite ACSC (1.2%, 95% confidence interval -1.6% to 4.1%) or for subgroup composites of acute and chronic ACSCs. Nor did we find a change in disparities in admission rates between black and white people (-1.9%, -8.5% to 5.1%) or white and Hispanic people (2.0%, -7.5% to 12.4%) for overall composite ACSC that existed in Massachusetts before reform. In analyses limited to Massachusetts only, we found no evidence of a change in admission rate for overall composite ACSC between counties with higher and lower rates of uninsurance at baseline (1.4%, -2.3% to 5.3%).
conclusionsMassachusetts reform was not associated with significantly lower overall or racial and ethnic disparities in rates of admission to hospital for ACSCs. In the US, and Massachusetts in particular, additional efforts might be needed to improve access to outpatient care and reduce preventable admissions.
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