ArticleWorld journal of surgery2019
Association of Medicaid Expansion Policy with Outcomes in Homeless Patients Requiring Emergency General Surgery.
Article in World journal of surgery, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed, 21 citations in OpenAlex.
- Review
- Impact of Medicaid Expansion on Abdominal Surgery Morbidity, Mortality, and Hospital Readmission.The Journal of surgical research · 2023Article
- Association of Hospital Discharge Against Medical Advice and Coded Housing Instability in the US.Journal of general internal medicine · 2023Article
- Medicaid Expansion Reduced Uninsured Surgical Hospitalizations And Associated Catastrophic Financial Burden.Health affairs (Project Hope) · 2021Article
- Comparison of Childbirth Delivery Outcomes and Costs of Care Between Women Experiencing vs Not Experiencing Homelessness.JAMA network open · 2021Article
- Association of Homelessness with Hospital Readmissions-an Analysis of Three Large States.Journal of general internal medicine · 2020Article
- Association between homelessness and opioid overdose and opioid-related hospital admissions/emergency department visits.Social science & medicine (1982) · 2019Article
- Demographics and Clinical Profiles of Patients Visiting a Free Clinic in Miami, Florida.Frontiers in public health · 2019Article
- A scoping review of surgical care for people experiencing homelessness: prevalence, access, and disparities.Canadian journal of surgery. Journal canadien de chirurgieArticle
Corrections and comments
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Authors and funding
12 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundMedicaid expansion has reduced obstacles faced in receiving care. Emergency general surgery (EGS) is a clinical event where delays in appropriate care impact outcomes. Therefore, we assessed the association between non-Medicaid expansion policy and multiple outcomes in homeless patients requiring EGS.
methodsWe used 2014 State Inpatient Database to identify homeless individuals admitted with a primary EGS diagnosis who underwent an EGS procedure. States were divided into those that did and did not implement Medicaid expansion. Multivariable quantile regression was used to examine associations between non-Medicaid expansion states and (1) length of stay and (2) total index hospital charges within the homeless population. Multivariable logistic regression was used to assess the associations between non-Medicaid expansion and (1) mortality, (2) surgical complications, (3) discharge against medical advice, and (4) home healthcare.
resultsA total of 6930 homeless patients were identified. Of these, 435 (6.2%) were in non-expansion states. Non-Medicaid expansion was associated with higher charges (coef: $46,264, 95% CI 40,388-52,139). There were non-significant differences in mortality (OR 1.4, 95% CI 0.79-2.62; p = 0.2) or surgical complications (OR 1.16, 95% CI 0.7-1.8; p = 0.4). However, homeless individuals living in non-expansion states did have higher odds of being discharged against medical advice (OR 2.1, 95% CI 1.08-4.05; p = 0.02), and lower odds of receiving home healthcare (OR 0.6, 95% CI 0.4-0.8; p = 0.01).
conclusionHomeless patients living in Medicaid expansion states had lower odds of being discharged against medical advice, higher likelihood of receiving home healthcare and overall lower total index hospital charges.
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