Addressing Medicaid Expansion from the Perspective of Patient Experience in Hospitals.
Patient
; 9(5): 445-55, 2016 10.
Article
en En
| MEDLINE
| ID: mdl-27002317
ABSTRACT
BACKGROUND:
More Medicaid holders are entering the healthcare system consequential to Medicaid expansion. Their experience has financial consequences for hospitals and crucial implications for the provision of patient-centered care. This study examined how the hospital characteristics, especially the rates of Medicaid coverage and racial/ethnic minorities, impact the quality of inpatient care.METHODS:
Using data for years 2009-2011 for 870 observations of California hospitals, and data collected from patients via the Hospital Consumer Assessment of Healthcare Providers and Systems survey coupled with data from the Healthcare Cost and Utilization Project and American Hospital Association Annual Survey, we used a generalized estimating equation approach to evaluate patients' experience with hospital care. Our multivariate model includes a comprehensive set of characteristics capturing market, structural, process, and patient demographics associated with the patient's hospital stay.RESULTS:
The findings indicate that high concentrations of Medicaid patients in the hospital negatively impact the perceived patient experience. In addition, all things being equal, hospitals with higher concentrations of Hispanic, Black, and Asian patients received lower patient satisfaction results on 28 of the 30 regression coefficients capturing patient satisfaction, with 22 of the 30 negative coefficients statistically significant.CONCLUSIONS:
Hospitals serving higher concentrations of Medicaid patients and more racial/ethnic diverse patients experienced a less satisfactory patient experience than patients utilizing other payers or patients who were White. Our research magnifies the challenge for addressing the disparities that exist in healthcare. Further research is called for clarifying the underlying reasons for these disparities and the optimal strategies for addressing these problems.
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Medicaid
/
Atención Dirigida al Paciente
/
Hospitales
Tipo de estudio:
Prognostic_studies
Aspecto:
Equity_inequality
Límite:
Humans
País/Región como asunto:
America do norte
Idioma:
En
Revista:
Patient
Año:
2016
Tipo del documento:
Article
País de afiliación:
Estados Unidos