Evidence map›Paper›PMID 31295216›Full record

ArticleSexually transmitted diseases2019

Changes in Patient Visits After the Implementation of Insurance Billing at a Sexually Transmitted Diseases Clinic in a Medicaid Expansion State.

Harry Jin, Brandon D L Marshall, Julia Raifman, Madeline Montgomery, Michaela A Maynard, Philip A Chan

Abstract read
In one paragraph

Article in Sexually transmitted diseases, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing 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

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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

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

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5 · Who and what money

Authors and funding

6 authors.

Harry JinFrom the Department of Epidemiology, Brown University School of Public Health, Providence, RI.
Brandon D L MarshallFrom the Department of Epidemiology, Brown University School of Public Health, Providence, RI.
Julia RaifmanDepartment of Health Law, Policy, and Management, Boston University School of Public Health, Boston, MA.
Madeline MontgomeryDepartment of Behavioral and Social Sciences, Brown University School of Public Health.
Michaela A MaynardDepartment of Medicine, Brown University, Providence, RI.
Philip A Chan

Funding

The Brown Initiative in HIV and AIDS Clinical Research for Minority CommunitiesR25MH083620 · NIMH · MIRIAM HOSPITAL · PI NUNN, AMY STEWART · 2008 to 2025
$3.7M
Characterizing the HIV pre-exposure prophylaxis care continuum for African American and Hispanic/Latino men who have sex with menR01MH114657 · NIMH · MIRIAM HOSPITAL · PI CHAN, PHILIP ANDREW, NUNN, AMY STEWART · 2017 to 2021
$3.4M
A Structural Approach to Improving HIV Pre-Exposure Prophylaxis (PrEP) Implementation among High Risk MenK01MH116817 · NIMH · BOSTON UNIVERSITY MEDICAL CAMPUS · PI RAIFMAN, JULIA · 2018 to 2021
$639k
NIMH NIH HHS K01 MH116817NIMH NIH HHS R01 MH114657NIMH NIH HHS R25 MH083620
6 · The paper itself

Abstract

backgroundMedicaid expansion has led to unique opportunities for sexually transmitted disease (STD) clinics to improve the sustainability of services by billing insurance. We evaluated changes in patient visits after the implementation of insurance billing at a STD clinic in a Medicaid expansion state.

methodsThe Rhode Island STD Clinic offered HIV/STD screening services at no cost to patients until October 2016, when insurance billing was implemented. Care for uninsured patients was still provided for free. We compared the clinic visits in the preinsurance period with the postinsurance period using t-tests, Poisson regressions, and a logistic regression.

resultsA total of 5560 patients were seen during the preinsurance (n = 2555) and postinsurance (n = 3005) periods. Compared with the preinsurance period, the postinsurance period had a significantly higher average number of patient visits/month (212.9 vs. 250.4, P = 0.0016), including among patients who were black (36.8 vs. 50.3, P = 0.0029), Hispanic/Latino (50.8 vs. 65.8, P = 0.0018), and insured (106.3 vs. 130.1, P = 0.0025). The growth rate of uninsured (+0.10 vs. +4.11, P = 0.0026) and new patients (-4.28 vs. +1.07, P = 0.0007) also increased between the two periods. New patients whose first visit was before the billing change had greater odds (adjusted odds ratio, 2.68, 95% confidence interval, 2.09-3.44; P < 0.0001) of returning compared with new patients whose first visit was after the billing change.

conclusionsImplementation of insurance billing at a publicly funded STD clinic, with free services provided to uninsured individuals, was associated with a modest increase in patient visits and a decline in patients returning for second visits.

Indexed as

Ambulatory CareAmbulatory Care FacilitiesFemaleHealth Care CostsHealth Plan ImplementationHealth Services AccessibilityHumansInsurance CoverageInsurance, HealthMaleMedicaidSexual and Gender MinoritiesSexually Transmitted DiseasesUnited States

Identifiers

PMID31295216
PMCPMC6636341

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