Evidence map›Paper›PMID 26974677›Full record

ArticleMedical care2016

Income Inequities and Medicaid Expansion are Related to Racial and Ethnic Disparities in Delayed or Forgone Care Due to Cost.

Cheryl R Clark, Mark J Ommerborn, Brent A Coull, Do Quyen Pham, Jennifer S Haas

Abstract read
In one paragraph

Article in Medical care, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers.

0numbers the graph read from it
0cells of the map it votes in
21citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

21 citing papers in PubMed.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Cheryl R Clark*The Center for Community Health and Health Equity, Brigham and Women's Hospital †Brigham and Women's-Faulkner Hospitalist Program ‡Division of General Medicine and Primary Care, Brigham and Women's Hospital §Department of Biostatistics, Harvard T. H. Chan School of Public Health, Boston, MA.
Mark J Ommerborn
Brent A Coull
Do Quyen Pham
Jennifer S Haas

Funding

HARVARD CLINICAL AND TRANSLATIONAL SCIENCE CENTER (UL1)UL1RR025758 · NCRR · HARVARD MEDICAL SCHOOL · PI NADLER, LEE MARSHALL · 2008 to 2011
$91.4M
Geographic Variation in Cardiovascular Inflammation in Middle-aged & Elderly PopuK08AG032357 · NIA · BRIGHAM AND WOMEN'S HOSPITAL · PI CLARK, CHERYL RENEE · 2009 to 2013
$634k
NCRR NIH HHS UL1 RR025758NIA NIH HHS K08 AG032357
6 · The paper itself

Abstract

backgroundMonitoring political and social determinants of delayed or forgone care due to cost is necessary to evaluate efforts to reduce racial and ethnic disparities in access to care. Our objective was to examine the extent to which state Medicaid expansion decisions and personal household income may be associated with individual-level racial and ethnic disparities in delayed or forgone care due to cost, at baseline, before the implementation of the Affordable Care Act.

methodsWe used 2012 Behavioral Risk Factor Surveillance System survey data to examine racial and ethnic differences in delayed or forgone care due to cost in states that do and do not plan Medicaid expansion. We examined personal household income as a social factor that could contribute to racial and ethnic disparities in delayed or forgone care.

resultsWe found that personal income differences were strongly related to disparities in delayed or forgone care in places with and without plans to expand Medicaid. In addition, while delayed or forgone care disparities between non-Hispanic whites and non-Hispanic blacks were lowest in places with plans to expand Medicaid access, disparities between non-Hispanic whites and Hispanics did not differ by state Medicaid expansion plans.

conclusionsAs access to insurance improves for diverse groups, health systems must develop innovative strategies to overcome social determinants of health, including income inequities, as barriers to accessing care for Hispanic and non-Hispanic blacks. Additional efforts may be needed to ensure Hispanic groups achieve the benefits of investments in health care access.

Indexed as

AdolescentAdultBehavioral Risk Factor Surveillance SystemBlack or African AmericanDelayed DiagnosisHealth Care CostsHealthcare DisparitiesHealth Services AccessibilityHispanic or LatinoHumansIncomeMedicaidMiddle AgedRacial GroupsUnited StatesWhite People

Identifiers

PMID26974677
PMCPMC5830941

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.