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ACA's Medicaid expansion associated with greater likelihood of patients receiving optimal care for serious surgical conditions

January 24, 2018

Bottom Line: The Affordable Care Act's (ACA's) Medicaid expansion was associated with significant increases in insurance coverage among patients with serious surgical conditions such as appendicitis or aortic aneurysm, and a greater likelihood of these patients receiving timely, optimal care.

Why The Research Is Interesting: Lack of insurance coverage has been associated with delays in seeking care, more complicated diseases at the time of diagnosis, and a decreased likelihood of receiving optimal surgical care. The ACA's Medicaid expansion has increased coverage among millions of low-income Americans, but its effect on care for common surgical conditions has not been known.

Who and When: 293,529 patients between the ages of 18 and 64 years with appendicitis, inflammation of the gallbladder, diverticulitis, peripheral artery disease or aortic aneurysm admitted to a hospital in 27 states that expanded Medicaid or 15 states that didn't to compare outcomes before (2010-2013) and after Medicaid expansion (2014-2015)

What (Study Measures): State adoption of Medicaid expansion (exposure); presentation of patients with early, uncomplicated disease and optimal surgical management of their conditions (outcomes)

How (Study Design): This was an observational study. Researchers were not intervening for purposes of the study and they cannot control all the natural differences that could explain study findings.

Authors: Andrew P. Loehrer, M.D., M.P.H., University of Texas MD Anderson Cancer Center, Houston, and coauthors.

Results:  ACA's Medicaid expansion was associated with increased insurance coverage of patients and improvement in receiving timely and optimal care for five common surgical conditions.

Study Limitations: Data are vulnerable to coding errors and study findings may not be generalizable for other medical conditions.
-end-
For more details and to read the full study, please visit the For The Media website.

(doi:10.1001/jamasurg.2017.5568)

Editor's Note: Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

Want to embed a link to this study in your story? Link will be live at the embargo time http://jamanetwork.com/journals/jamasurgery/fullarticle/10.1001/jamasurg.2017.5568

JAMA Surgery

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