ArticleBirth defects research2021
Disparities in insurance coverage among hospitalized adult congenital heart disease patients before and after the Affordable Care Act.
Article in Birth defects research, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers.
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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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Who cites it
18 citing papers in PubMed, 24 citations in OpenAlex.
- Clinical characteristics and healthcare utilization of adults with congenital heart disease on Medicaid insurance in the United States.International journal of cardiology. Congenital heart disease · 2026Article
- Racial and Ethnic Differences in Healthcare Access and Utilization Among Adults With Congenital Heart Defects in the Congenital Heart Survey to Recognize Outcomes, Needs and Well-Being (CH STRONG).Birth defects research · 2026Article
- Economic Barriers to Interventional Cardiology Care for Adults and Children With Congenital Heart Disease and Potential Policy Solutions: A SCAI Policy Statement.Journal of the Society for Cardiovascular Angiography & Interventions · 2025Article
- Disparities in disease burden of congenital heart disease among 150,488 individuals in Western China.Scientific reports · 2025Article
- Association between insurance type, clinical characteristics, and healthcare use in adults with congenital heart disease.International journal of cardiology. Congenital heart disease · 2024Article
- Health Insurance Status and Access to Healthcare Among Young Adults with Congenital Heart Disease: from the Congenital Heart Survey To Recognize Outcomes, Needs and Well-beinG (CH STRONG), 2016-2019.Pediatric cardiology · 2024Article
- Impact of Social Determinants of Health on Outcomes for Patients with Adult Congenital Heart Disease.Current cardiology reports · 2024Review
- Access to Specialized Care Across the Lifespan in Tetralogy of Fallot.CJC pediatric and congenital heart disease · 2023Review
- Does universal insurance influence disparities in high-quality hospital use for inpatient pediatric congenital heart defect care within the first year of diagnosis?BMC health services research · 2023Article
- Lesion-specific mortality due to congenital heart disease in U.S. adults from 1999 to 2017.Birth defects research · 2022Article
- Hope is No Plan: Uncovering Actively Missing Transition-Aged Youth with Congenital Heart Disease.Pediatric cardiology · 2022Article
- Health and Dental Insurance and Health Care Utilization Among Children, Adolescents, and Young Adults With CKD: Findings From the CKiD Cohort Study.Kidney medicine · 2022Article
- Addressing Social Determinants of Health and Mitigating Health Disparities Across the Lifespan in Congenital Heart Disease: A Scientific Statement From the American Heart Association.Journal of the American Heart Association · 2022Review
- Operational and Ethical Considerations for a National Adult Congenital Heart Disease Database.Journal of the American Heart Association · 2022Article
- Advances in Managing Transition to Adulthood for Adolescents With Congenital Heart Disease: A Practical Approach to Transition Program Design: A Scientific Statement From the American Heart Association.Journal of the American Heart Association · 2022Review
- Increased prevalence of cardiac and non-cardiac chronic morbidity among adults with congenital heart disease.International journal of cardiology. Congenital heart disease · 2022Article
- Socioeconomic Factors and their Impact on Access and Use of Coronary and Structural Interventions.European cardiology · 2022Review
- Healthcare utilization trends for adolescents and young adults with moderate and severe congenital heart disease.Annals of pediatric cardiologyArticle
Corrections and comments
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Authors and funding
4 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundData are lacking regarding the insurance status of adults with congenital heart disease (ACHD). We investigated whether the Affordable Care Act (ACA) impacted insurance status among hospitalized ACHD, identified associated sociodemographic factors, and compared coverage to adults with other chronic childhood conditions.
methodsSerial cross-sectional analysis of National Inpatient Sample hospitalizations from 2007 to 2016 was performed for patients 18-64 years old. ACHD were identified using ICD-9/10-CM codes and compared to patients with sickle cell disease (SCD), cystic fibrosis (CF), and the general population. Age was dichotomized as 18-25 years (transition aged) or 26-64 years. Groups were compared by era (pre-ACA [January 2007-June 2010]; early-ACA [July 2010-December 2013], which eliminated pre-existing condition exclusions; and full-ACA [January 2014-December 2016]) using interrupted time series and multivariable Poisson regression analyses.
resultsOverall, uninsured hospitalizations decreased from pre-ACA (12.0%) to full-ACA (8.5%). After full ACA implementation, ACHD had lower uninsured rates than the general hospitalized population (6.0 vs. 8.6%, p < .01), but higher rates than those with other chronic childhood diseases (SCD [4.5%]; CF [1.6%]). Across ACA eras, transition aged ACHD had higher uninsured rates than older patients (8.9 vs. 7.6%, p < .01), and Hispanic patients remained less insured than other groups.
conclusionsHospitalized ACHD were better insured than the general population but less insured than those with SCD or CF. Full ACA implementation was associated with improved insurance coverage for all groups, but disparities persisted for transition aged and Hispanic patients. Ongoing evaluation of the effects of insurance and health policy on ACHD remains critical to diminish health disparities.
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