Evidence map›Paper›PMID 30807452›Full record

ArticleMedical care2019

Racial Differences in Insurance Stability After Health Insurance Reform.

Karen M Freund, Amy LeClair, Norma Terrin, Amresh D Hanchate, Lori Lyn Price, Alejandro Moreno-Koehler, Jill Suzukida, Sucharita Kher, Elena Byhoff, Nancy R Kressin

Abstract read
In one paragraph

Article in Medical care, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing 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

2 citing papers in PubMed.

  1. Observational
  2. Article
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

10 authors.

Karen M FreundThe Institute for Clinical Research and Health Policy Studies, Tufts Medical Center.
Amy LeClairThe Institute for Clinical Research and Health Policy Studies, Tufts Medical Center.
Norma TerrinThe Institute for Clinical Research and Health Policy Studies, Tufts Medical Center.
Amresh D HanchateBoston University School of Medicine.
Lori Lyn PriceThe Institute for Clinical Research and Health Policy Studies, Tufts Medical Center.
Alejandro Moreno-KoehlerTufts Clinical and Translational Science Institute, Tufts University.
Jill SuzukidaDepartment of Medicine, Division of Internal Medicine and Primary Care, Tufts Medical Center.
Sucharita KherDepartment of Medicine, Division of Pulmonary, Critical Care, and Sleep Medicine, Tufts Medical Center, Tufts University, Boston.
Elena ByhoffThe Institute for Clinical Research and Health Policy Studies, Tufts Medical Center.
Nancy R KressinBoston University School of Medicine.

Funding

Tufts Clinical and Translational Science Institute (Pilot Supplement)UL1TR002544 · NCATS · TUFTS UNIVERSITY BOSTON · PI SELKER, HARRY P. · 2018 to 2022
$50.2M
Tufts Clinical and Translational Research InstituteUL1TR001064 · NCATS · TUFTS UNIVERSITY BOSTON · PI SELKER, HARRY P. · 2013 to 2017
$26.4M
Insurance Instability and Disparities in Chronic Disease OutcomesR01MD007735 · NIMHD · TUFTS MEDICAL CENTER · PI FREUND, KAREN, KRESSIN, NANCY R. · 2014 to 2017
$1.8M
NCATS NIH HHS UL1 TR001064NCATS NIH HHS UL1 TR002544NIMHD NIH HHS R01 MD007735
6 · The paper itself

Abstract

backgroundOne of the potential benefits of insurance reform is greater stability of insurance and reduced coverage disparities by race and ethnicity.

objectivesWe examined the temporal trends in insurance coverage by racial/ethnic group before and after Massachusetts Insurance Reform by abstracting records across 2 urban safety net hospital systems. RESEARCH

designWe examined adjusted odds of being uninsured and incident rate ratios of gaining and losing insurance over time by race and ethnicity. We used billing records to capture the payer for each episode of care. SUBJECTS: We included data from January 2005 through December 2013 on patients with hypertension between the ages of 21 and 64 years. We compared 4 racial and ethnic groups: non-Hispanic white, non-Hispanic Black, non-Hispanic Asian, and Hispanic. MEASURES: We examined individual patients' insurance coverage status in 6-month intervals. We compared odds of being uninsured in the transition and postinsurance reform period to the prereform period, adjusting for age, sex, comorbidities practice location and education, and income by Census tract.

resultsAmong 48,291 patients with hypertension, reduction in rates of uninsurance with insurance reform was greater for Hispanic (29.7%), non-Hispanic Black (24.8%), and non-Hispanic Asian (26.8%) than non-Hispanic white (14.9%) patients. The odds of becoming uninsured were reduced in all racial and ethnic groups (odds ratio, 0.27-0.41).

conclusionsMassachusetts Insurance Reform resulted in stable insurance coverage and a reduction in disparities in insurance instability by race and ethnicity.

Indexed as

Health Care ReformAdultEthnicityFemaleHealthcare DisparitiesHumansHypertensionInsurance CoverageInsurance, HealthMaleMassachusettsMedically UninsuredMiddle AgedRacial GroupsSafety-net ProvidersTime Factors

Identifiers

PMID30807452
PMCPMC6605092

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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.