ArticleAnnals of surgery2016
Impact of Expanded Insurance Coverage on Racial Disparities in Vascular Disease: Insights From Massachusetts.
Article in Annals of surgery, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 1 of them a synthesis that pooled it.
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Who cites it
22 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Disparities in Surgical Access: A Systematic Literature Review, Conceptual Model, and Evidence Map.Journal of the American College of Surgeons · 2019Pooled it
- Trends and disparities in skin malignant neoplasm mortality in the United States: a 22-year trend analysis based on CDC WONDER Data (1999-2020).Frontiers in oncology · 2026Article
- Racial and Socioeconomic Health Disparities in Peripheral Artery Disease.Journal of the American Heart Association · 2024Review
- Disparities in healthcare utilization by insurance status among patients with symptomatic peripheral artery disease.BMC health services research · 2023Article
- Real-World Racial Variation in Treatment and Outcomes Among Patients with Peripheral Artery Disease.Advances in therapy · 2023Article
- Disparities in peripheral artery disease care: A review and call for action.Seminars in vascular surgery · 2022Review
- Rates of Diabetes-Related Major Amputations Among Racial and Ethnic Minority Adults Following Medicaid Expansion Under the Patient Protection and Affordable Care Act.JAMA network open · 2022Article
- Racial disparities in surgical management and outcomes of acute limb ischemia in the United States.Surgery open science · 2021Article
- Association of Cost Sharing With Delayed and Complicated Presentation of Acute Appendicitis or Diverticulitis.JAMA health forum · 2021Article
- Association between race/ethnicity and the risk of amputation of lower extremities among medicare beneficiaries with diabetic foot ulcers and diabetic foot infections.BMJ open diabetes research & care · 2020Article
- Race and socioeconomic differences associated with endovascular peripheral vascular interventions for newly diagnosed claudication.Journal of vascular surgery · 2020Article
- Treatment of Acute Cholecystitis: Do Medicaid and Non-Medicaid Enrolled Patients Receive the Same Care?Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2020Article
- Article
- Incidence of thyroid cancer in Puerto Rico and the US by racial/ethnic group, 2011-2015.BMC cancer · 2019Article
- Racial factors and inpatient outcomes among patients with diabetes hospitalized with foot ulcers and foot infections, 2003-2014.PloS one · 2019Article
- Review
- Association of the Affordable Care Act Medicaid Expansion With Access to and Quality of Care for Surgical Conditions.JAMA surgery · 2018Article
- Race and Socioeconomic Status Independently Affect Risk of Major Amputation in Peripheral Artery Disease.Journal of the American Heart Association · 2018Observational
- The effect of race on postsurgical ambulatory medical follow-up among United States Veterans.Journal of clinical anesthesia · 2017Observational
- Article
Corrections and comments
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Authors and funding
6 authors.
Funding
Abstract
objectiveTo evaluate the impact of health insurance expansion on racial disparities in severity of peripheral arterial disease.
backgroundLack of insurance and non-white race are associated with increased severity, increased amputation rates, and decreased revascularization rates in patients with peripheral artery disease (PAD). Little is known about how expanded insurance coverage affects disparities in presentation with and management of PAD. The 2006 Massachusetts health reform expanded coverage to 98% of residents and provided the framework for the Affordable Care Act.
methodsWe conducted a retrospective cohort study of nonelderly, white and non-white patients admitted with PAD in Massachusetts (MA) and 4 control states. Risk-adjusted difference-in-differences models were used to evaluate changes in probability of presenting with severe disease. Multivariable linear regression models were used to evaluate disparities in disease severity before and after the 2006 health insurance expansion.
resultsBefore the 2006 MA insurance expansion, non-white patients in both MA and control states had a 12 to 13 percentage-point higher probability of presenting with severe disease (P < 0.001) than white patients. After the expansion, measured disparities in disease severity by patient race were no longer statistically significant in Massachusetts (+3.0 percentage-point difference, P = 0.385) whereas disparities persisted in control states (+10.0 percentage-point difference, P < 0.001). Overall, non-white patients in MA had an 11.2 percentage-point decreased probability of severe PAD (P = 0.042) relative to concurrent trends in control states.
conclusionsThe 2006 Massachusetts insurance expansion was associated with a decreased probability of patients presenting with severe PAD and resolution of measured racial disparities in severe PAD in MA.
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