ArticleBMC health services research2019
Investigating the causal effect of socioeconomic status on quality of care under a universal health insurance system - a marginal structural model approach.
Article in BMC health services research, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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Who cites it
11 citing papers in PubMed, 22 citations in OpenAlex.
- Post-traumatic stress disorder and risk of all-cause and cause-specific mortality: a nationwide population and sibling-controlled cohort study in Taiwan.Epidemiology and psychiatric sciences · 2026Article
- Social Adversity Is Causally Linked to Multimorbidity Including Oral Conditions.Journal of dental research · 2026Article
- Social inequities in general health and oral health among Australian adults over time.BMC public health · 2025Article
- Mortality among transgender persons: a Taiwan matched-population and sibling-comparison cohort study.The Lancet regional health. Western Pacific · 2025Article
- Optimizing pediatric emergency triage in low-resource settings: evidence-based strategies, task-shifting, and technological innovations.International journal of emergency medicine · 2025Review
- Association between spatial access and hospitalization for ambulatory care sensitive conditions: A retrospective cohort study using claims data.SSM - population health · 2024Article
- Article
- The association between socioeconomic status and use of potentially inappropriate medications in older adults.Journal of the American Geriatrics Society · 2023Article
- Examining Global Wellness, Anxiety Severity, and Depression Severity among Black and Latinx Adults: Implications for Counseling.Journal of mental health counseling · 2023Article
- Are Income-based Differences in TKA Use and Outcomes Reduced in a Single-payer System? A Large-database Comparison of the United States and Canada.Clinical orthopaedics and related research · 2022Article
- An Adolescent-Caregiver Dyad Approach to Climate Anxiety in the Pediatric Emergency Department.Inquiry : a journal of medical care organization, provision and financingArticle
Corrections and comments
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Authors and funding
6 authors at 5 institutions in 3 countries.
Funding
Abstract
backgroundSocial disparities in healthcare persist in the US despite the expansion of Medicaid under the Affordable Care Act. We investigated the causal impact of socioeconomic status on the quality of care in a setting with minimal confounding bias from race, insurance type, and access to care.
methodsWe designed a retrospective population-based study with a random 25% sample of adult Taiwan population enrolled in Taiwan's National Health Insurance system from 2000 to 2016. Patient's income levels were categorized into low-income group (<25th percentile) and high-income group (≥25th percentile). We used marginal structural modeling analysis to calculate the odds of hospital admissions for 11 ambulatory care sensitive conditions identified by the Agency for Healthcare Research and Quality and the odds of having an Elixhauser comorbidity index greater than zero for low-income patients.
resultsAmong 2,844,334 patients, those in lower-income group had 1.28 greater odds (95% CI 1.24-1.33) of experiencing preventable hospitalizations, and 1.04 greater odds (95% CI 1.03-1.05) of having a comorbid condition in comparison to high-income group.
conclusionsIncome was shown to be a causal factor in a patient's health and a determinant of the quality of care received even with equitable access to care under a universal health insurance system. Policies focusing on addressing income as an important upstream causal determinant of health to provide support to patients in lower socioeconomic status will be effective in improving health outcomes for this vulnerable social stratum.
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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.