Evidence map›Paper›PMID 39949206›Full record

ArticleJournal of primary care & community health

The Impact of Medicaid Expansion on Acute Diabetes Complication by Care Delivery Settings.

Danielle Kulbak, Dang Dinh, Annie E Larson, Andrew Suchocki, Rachel Springer, Miguel Marino, Jennifer E DeVoe, Jun Hwang, Nathalie Huguet

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of primary care & community health. 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

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

1 citing paper in PubMed.

  1. 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

9 authors.

Danielle KulbakA.T. Still University, Mesa, AZ, USA.ORCID 0009-0008-6493-8491
Dang DinhOregon Health & Science University, Portland, OR, USA.
Annie E LarsonOCHIN Inc., Portland, OR, USA.ORCID 0000-0002-0080-3220
Andrew SuchockiClackamas Health Centers, Oregon City, OR, USA.
Rachel SpringerOregon Health & Science University, Portland, OR, USA.
Miguel MarinoOregon Health & Science University, Portland, OR, USA.
Jennifer E DeVoeOregon Health & Science University, Portland, OR, USA.
Jun HwangOregon Health & Science University, Portland, OR, USA.
Nathalie HuguetOregon Health & Science University, Portland, OR, USA.ORCID 0000-0002-4064-1553

Funding

CDC HHSNCCDPHP CDC HHS U18 DP006536
6 · The paper itself

Abstract

objectiveThis study evaluates whether gaining Medicaid following the Affordable Care Act (ACA) expansion led to changes in the rate of acute diabetes complications diagnosed in primary care settings, relative to in inpatient, emergency department (ED), or urgent care (UC) settings.

methodsThis retrospective cohort study used Medicaid administrative claims data linked to electronic health records for 3767 patients, aged 19 to 64 years, who experienced acute preventable complications of diabetes between 2014 and 2019 diagnosed in inpatient, ED, UC, or primary care settings in the state of Oregon. These patients were classified as either continuously Medicaid-insured or having gained Medicaid.

resultsAnnual rates of acute complications diagnosed in primary care and inpatient/ED/UC settings increased for both continuously [Adjusted Rate Ratio (aRR) = 2.20, 95% CI = 1.65-2.91] and newly Medicaid-insured patients (aRR = 2.67, 95% CI = 2.05-3.47) after the ACA. Among newly Medicaid-insured, annual rates of abnormal blood glucose diagnosed in primary care settings significantly increased with time while those diagnosed in inpatient/ED/UC decreased (2014 vs 2016 aRR = 3.36, 95% CI = 1.60-7.09).

conclusionWe found a significantly greater rate of abnormal blood glucose diagnosed in primary care clinics among patients who gained Medicaid post-ACA and a corresponding decline in diagnosis in inpatient/ED/UC settings.

Indexed as

Diabetes ComplicationsMedicaidPatient Protection and Affordable Care ActPrimary Health CareAdultEmergency Service, HospitalFemaleHumansMaleMiddle AgedOregonRetrospective StudiesUnited StatesYoung Adultcommunity health centerdiabete complicationemergency departmentinpatientMedicaidprimary care

Identifiers

PMID39949206
PMCPMC11826838

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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.