ArticleJAMA surgery2017
Association of Expanded Medicaid Coverage With Hospital Length of Stay After Injury.
Article in JAMA surgery, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 1 of them a synthesis that pooled it.
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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.
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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.
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Who cites it
11 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Caesarean section in uninsured women in the USA: systematic review and meta-analysis.BMJ open · 2019Pooled it
- Prolonged Length of Stay at Out-of-State Trauma Centers: Potential Role for Repatriation.Journal of the American College of Surgeons · 2025Article
- Examining the effects of race/ethnicity and other factors on outcomes of care for complex regional pain syndrome type 1 in the United States.PLOS global public health · 2025Article
- Are There Racial and Ethnic Disparities in Management and Outcomes of Surgically Treated Distal Radius Fractures?Hand (New York, N.Y.) · 2024Article
- Urban Traumatic Moving Injuries Before and During SARS-CoV-2: A Multilinear Regression Analysis.Cureus · 2023Article
- The Affordable Care Act and its Effects on Trauma Care Access, Short- and Long-term Outcomes and Financial Impact: A Review Article.Annals of surgery open : perspectives of surgical history, education, and clinical approaches · 2022Review
- Association of the Affordable Care Act Medicaid Expansion with Trauma Outcomes and Access to Rehabilitation among Young Adults: Findings Overall, by Race and Ethnicity, and Community Income Level.Journal of the American College of Surgeons · 2021Article
- Association of Medicaid Expansion With Access to Rehabilitative Care in Adult Trauma Patients.JAMA surgery · 2019Article
- Understanding Disparities in Surgical Outcomes for Medicaid Beneficiaries.World journal of surgery · 2019Article
- Article
- Medicaid Expansion and Racial/Ethnic Differences in Readmission After Acute Ischemic Stroke.Inquiry : a journal of medical care organization, provision and financingArticle
Corrections and comments
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Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
importanceThe expansion of Medicaid eligibility under the Affordable Care Act is a state-level decision that affects how patients with traumatic injury (trauma patients) interact with locoregional health care systems. Washington, DC; Maryland; and Virginia represent 3 unique payer systems with liberal, moderate, and no Medicaid expansion, respectively, under the Affordable Care Act. Characterizing the association of Medicaid expansion with hospitalization after injury is vital in the disposition planning for these patients.
objectiveTo determine the association between expanded Medicaid eligibility under the Affordable Care Act and duration of hospitalization after injury. DESIGN, SETTING, AND
participantsThis retrospective cohort study included patients admitted from Virginia, Maryland, and Washington, DC, to a single level I trauma center. Data were collected from January 1, 2013, through March 6, 2016, in Virginia and Washington, DC, and from May 1, 2013, through March 6, 2016, in Maryland. All patients with Medicare or Medicaid coverage and all uninsured patients were included. Patients with private insurance, patients with severe head or pelvic injuries, and those who died during hospitalization were excluded. MAIN OUTCOMES AND MEASURES: Hospital length of stay (LOS) and whether its association with patient insurance status varied by state of residence.
resultsA total of 2314 patients (1541 men [66.6%] and 773 women [33.4%]; mean [SD] age, 52.9 [22.8] years) were enrolled in the study. The uninsured rate in the Washington, DC, cohort (190 of 1699 [11.2%]) was significantly lower compared with rates in the Virginia (141 of 296 [47.6%]) or the Maryland (106 of 319 [33.2%]) cohort (P < .001). On multivariate regression controlling for injury severity and demographic variables, the difference in LOS for Medicaid vs non-Medicaid recipients varied significantly by state. For Medicaid recipients, mean LOS in Washington, DC, was significantly shorter (2.57 days; 95% CI, 2.36-2.79 days) than in Maryland (3.51 days; 95% CI, 2.81-4.38 days; P = .02) or Virginia (3.9 days; 95% CI, 2.79-5.45 days; P = .05). CONCLUSIONS AND RELEVANCE: Expanded Medicaid eligibility is associated with shorter hospital LOS in mildly injured Medicaid recipients.
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