ArticleJournal of general internal medicine2017
Medicaid's Impact on Chronic Disease Biomarkers: A Cohort Study of Community Health Center Patients.
Article in Journal of general internal medicine, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 10 papers, 1 of them a synthesis that pooled 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.
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.
Assessing a Medicaid Randomized Insurance Experiment Within Community Clinics
Post Affordable Care Act: Evaluation of Community Health Centers
Who cites it
10 citing papers in PubMed, 1 synthesis or guideline pooled it, 14 citations in OpenAlex.
- Association of Economic Policies With Hypertension Management and Control: A Systematic Review.JAMA health forum · 2024Pooled it
- ActionHealthNYC: Effectiveness of a Health Care Access Program for the Uninsured, 2016-2017.American journal of public health · 2021Trial
- A cohort of patients in New York State with an alcohol use disorder and subsequent treatment information - A merging of two administrative data sources.Journal of biomedical informatics · 2023Article
- Telephone or Visit-Based Community Health Worker Care Management for Uncontrolled Diabetes Mellitus: A Longitudinal Study.Journal of community health · 2020Article
- The Affordable Care Act: Effects of Insurance on Diabetes Biomarkers.Diabetes care · 2020Observational
- Disparities in Biomarkers for Patients With Diabetes After the Affordable Care Act.Medical care · 2020Article
- Medicaid coverage accuracy in electronic health records.Preventive medicine reports · 2018Article
- The Affordable Care Act Decreased the Proportion of Uninsured Patients in a Safety Net Orthopaedic Clinic.Clinical orthopaedics and related research · 2018Article
- Uninsured Primary Care Visit Disparities Under the Affordable Care Act.Annals of family medicine · 2017Observational
- Diabetes and Hypertension Prevention and Control in Community Health Centers: Impact of the Affordable Care Act.Journal of primary care & community healthArticle
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundUnderstanding the impact of health insurance is critical, particularly in the era of Affordable Care Act Medicaid expansion. The electronic health record (EHR) provides new opportunities to quantify health outcomes.
objectiveTo assess changes in biomarkers of chronic disease among community health center (CHC) patients who gained Medicaid coverage with the Oregon Medicaid expansion (2008-2011).
designProspective cohort. Patients were followed for 24 months, and rate of mean biomarker change was calculated. Time to a controlled follow-up measurement was compared using Cox regression models. SETTING/PATIENTS: Using EHR data from OCHIN (a non-profit network of CHCs) linked to state Medicaid data, we identified three cohorts of patients with uncontrolled chronic conditions (diabetes, hypertension, and hyperlipidemia). Within these cohorts, we included patients who gained Medicaid coverage along with a propensity score-matched comparison group who remained uninsured (diabetes n = 608; hypertension n = 1244; hyperlipidemia n = 546). MAIN MEASURES: Hemoglobin A1c (HbA1c) for the diabetes cohort, systolic and diastolic blood pressure (SBP and DBP, respectively) for the hypertension cohort, and low-density lipoprotein (LDL) for the hyperlipidemia cohort. KEY
resultsAll cohorts improved over time. Compared to matched uninsured patients, adults in the diabetes and hypertension cohorts who gained Medicaid coverage were significantly more likely to have a follow-up controlled measurement (hazard ratio [HR] =1.26, p = 0.020; HR = 1.35, p < 0.001, respectively). No significant difference was observed in the hyperlipidemia cohort (HR = 1.09, p = 0.392).
conclusionsOCHIN patients with uncontrolled chronic conditions experienced objective health improvements over time. In two of three chronic disease cohorts, those who gained Medicaid coverage were more likely to achieve a controlled measurement than those who remained uninsured. These findings demonstrate the effective care provided by CHCs and the importance of health insurance coverage within a usual source of care setting. CLINICAL TRIALS REGISTRATION: NCT02355132 [ https://clinicaltrials.gov/ct2/show/NCT02355132 ].
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
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.