Sampling coverage of the Arkansas all-payer claims database by County's persistent poverty designation.
Health Serv Res
; 59(4): e14342, 2024 08.
Article
em En
| MEDLINE
| ID: mdl-38880660
ABSTRACT
OBJECTIVES:
To evaluate the quality of Arkansas All-Payer Claims Database (APCD) for disparity research in persistent poverty areas by determining (1) its representativeness of Arkansas population, (2) variation by county, and (3) differences in coverage between persistent poverty and other counties. DATA SOURCES Cross-sectional study using 2019 Arkansas APCD member enrollment data and county-level data from various agencies. DATA COLLECTION/EXTRACTIONMETHODS:
An alias identifier linked persons across insurance plans. County FIPS codes were used to extract county-level variables. STUDYDESIGN:
Cohort 1 included individuals with ≥1 day of medical coverage in 2019. Cohort 2 included individuals with medical coverage in June, 2019. Cohort 3 included individuals with continuous medical coverage in 2019. Sampling proportions of a county's population in the three cohorts were compared between persistent poverty and other counties. Inverse-variance weighted linear regression was used to identify county-level socioeconomic and demographic characteristics associated with inclusion in each cohort. PRINCIPALFINDINGS:
In 2019, 73.6% of Arkansans had medical coverage for ≥1 day (Cohort 1), 66.3% had coverage in June (Cohort 2), and 58.8% had continuous coverage (Cohort 3) in APCD. Sampling proportions varied by county (median[range] Cohort 1, 78% [58%-95%]; Cohort 2, 71% [51%-88%]; and Cohort 3, 64% [44%-80%]), and were higher among persistent poverty counties than others for all three cohorts (mean [SD], persistent poverty vs. other Cohort 1 80.9% [6.4%] vs. 77.1% [6.3%], p = 0.04; Cohort 2 74.0% [6.4%] vs. 70.1% [6.2%], p = 0.03; Cohort 3 66.4% [6.1%] vs. 62.7% [6.0%], p = 0.03). In the 2019 APCD, larger counties and those with higher proportions of females or persons 65+ years had higher coverage, whereas counties with higher per capita household income, median home value, or disproportionately more persons of other races (non-White and non-Black) had lower coverage (p < 0.05 for all three cohorts).CONCLUSIONS:
The Arkansas APCD had good coverage of Arkansas population. Coverage was higher in persistent poverty counties than others.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Pobreza
Limite:
Adolescent
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Adult
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Aged
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Child
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Child, preschool
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Female
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Humans
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Infant
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Male
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Middle aged
País/Região como assunto:
America do norte
Idioma:
En
Revista:
Health Serv Res
Ano de publicação:
2024
Tipo de documento:
Article
País de afiliação:
Estados Unidos