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Health Care Use Among Patients Retroactively Insured via a Hospital-Based Insurance Linkage Program.
Eisinger, Ella C; Chen, Angela T; Ramadan, Omar I; Morgan, Anna U; Delgado, M Kit; Kaufman, Elinore J.
Afiliação
  • Eisinger EC; The Center for Surgical Health, University of Pennsylvania, Philadelphia, PA, USA.
  • Chen AT; Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
  • Ramadan OI; The Center for Surgical Health, University of Pennsylvania, Philadelphia, PA, USA.
  • Morgan AU; Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
  • Delgado MK; Health Care Management Department, The Wharton School, University of Pennsylvania, Philadelphia, PA, USA.
  • Kaufman EJ; The Center for Surgical Health, University of Pennsylvania, Philadelphia, PA, USA.
J Gen Intern Med ; 39(11): 1977-1984, 2024 Aug.
Article em En | MEDLINE | ID: mdl-38483779
ABSTRACT

OBJECTIVE:

Over 25% of the 27 million uninsured individuals in the United States are eligible for Medicaid. Many hospitals have insurance linkage programs that assist eligible patients with enrollment, but little is known about the impact of these programs on care utilization. This research assessed health care utilization and health outcomes among patients enrolled in Medicaid via a hospital-based insurance linkage program.

METHODS:

This retrospective cohort study included adults aged 18-64 admitted to the hospital from 2016 to 2021. Those who obtained insurance retroactively via insurance linkage (RI) were compared with those who presented with Medicaid (MI) or remained uninsured (UI). The primary outcome was the presence of at least one visit with a primary care provider (PCP) in the 12 months following index admission. Secondary outcomes included having an assigned PCP, ED revisits, and hospital readmissions. For patients with diabetes and hypertension, 12-month hemoglobin A1c (HbA1c) and blood pressure (BP) readings were tracked.

RESULTS:

Of 3882 patients admitted with no insurance, 2905 (74.8%) were enrolled in insurance (RI). In multivariable analysis, RI patients were 14% more likely (OR 1.14, p = 0.020) to have completed at least one PCP visit by 12 months after index admission compared to those with preexisting Medicaid (MI), and uninsured patients were 29% less likely (OR 0.71, p = 0.003). MI and RI patients also had more ED revisits (p < 0.001) and greater 12-month reductions in blood pressure (p < 0.001) compared with uninsured patients.

CONCLUSION:

Hospital-based insurance linkage reached three-quarters of uninsured patients and was associated with increased utilization of acute and outpatient health care services. An acute care encounter represents an opportunity to connect patients to insurance, a key step toward improving their health outcomes.
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Texto completo: 1 Base de dados: MEDLINE Assunto principal: Aceitação pelo Paciente de Cuidados de Saúde / Medicaid / Pessoas sem Cobertura de Seguro de Saúde / Seguro Saúde Limite: Adolescent / Adult / Female / Humans / Male / Middle aged País/Região como assunto: America do norte Idioma: En Ano de publicação: 2024

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Aceitação pelo Paciente de Cuidados de Saúde / Medicaid / Pessoas sem Cobertura de Seguro de Saúde / Seguro Saúde Limite: Adolescent / Adult / Female / Humans / Male / Middle aged País/Região como assunto: America do norte Idioma: En Ano de publicação: 2024