Nav: Home

The association between Medicare eligibility and rehabilitative care

June 01, 2016

In Annals of Surgery: The Association Between Medicare Eligibility and Rehabilitative Care For Patients Aged 64 versus 65 Years

Rehabilitation is an essential component of high-quality health care. Several studies have shown that insurance status is a key factor in determining a patient's access to rehab, but little is known about how recent policy changes have affected insurance coverage and therefore access to rehab. Using regression discontinuity (RD) models, researchers at the Center for Surgery and Public Health at Brigham and Women's Hospital found that becoming Medicare eligible at age 65 (as compared to age 64) was associated with an abrupt 6.4 percentage-point decline in the number of people who were uninsured and a 9.6 percentage-point increase in rehabilitation. In other words, Medicare coverage was associated with a significant gain in access, allowing an additional one-in-ten patients to take advantage of rehabilitative care.

The study, published in Annals of Surgery, used RD models to examine the extent to which insurance changes were associated with variations in rehabilitation access/use among adults ages 64 versus 65 years old (the age at which they became eligible for Medicare), using data extracted from the 2007-2012 National Trauma Data Bank.

RD models are quasi-experimental, and designed to mimic the results of randomized controlled trials. Developed for use in educational psychology and economics, this is the first time that they have been employed in a surgical outcomes study.

"As a nation, it's imperative that we continue to study the impact of ongoing healthcare reform, particularly when it comes to the effect that health insurance status has on access to rehabilitation," explained Adil Haider, MD, MPH, FACS, lead author of the study and Kessler Director of the Center for Surgery and Public Health. "We must carefully consider how patients, especially older adults, are accessing rehab. Whether it's discharge to a skilled nursing facility, acute inpatient facility, or care provided at home, rehabilitation is a key step in the healing and recovery process and every patient deserves equitable access."

Paper cited: Zogg C.K. et. al. "The Association Between Medicare Eligibility and Gains in Access to Rehabilitative Care: A National Regression Discontinuity Assessment of Patients Aged 64 versus 65 Years." Annals of Surgery. DOI: 10.1097/SLA.0000000000001754
-end-


Brigham and Women's Hospital

Related Public Health Articles:

Pandemic likely to cause long-term health problems, Yale School of Public Health finds
The coronavirus pandemic's life-altering effects are likely to result in lasting physical and mental health consequences for many people--particularly those from vulnerable populations--a new study led by the Yale School of Public Health finds.
The Lancet Public Health: US modelling study estimates impact of school closures for COVID-19 on US health-care workforce and associated mortality
US policymakers considering physical distancing measures to slow the spread of COVID-19 face a difficult trade-off between closing schools to reduce transmission and new cases, and potential health-care worker absenteeism due to additional childcare needs that could ultimately increase mortality from COVID-19, according to new modelling research published in The Lancet Public Health journal.
The Lancet Public Health: Access to identification documents reflecting gender identity may improve trans mental health
Results from a survey of over 20,000 American trans adults suggest that having access to identification documents which reflect their identified gender helps to improve their mental health and may reduce suicidal thoughts, according to a study published in The Lancet Public Health journal.
The Lancet Public Health: Study estimates mental health impact of welfare reform, Universal Credit, in Great Britain
The 2013 Universal Credit welfare reform appears to have led to an increase in the prevalence of psychological distress among unemployed recipients, according to a nationally representative study following more than 52,000 working-age individuals from England, Wales, and Scotland over nine years between 2009-2018, published as part of an issue of The Lancet Public Health journal on income and health.
BU researchers: Pornography is not a 'public health crisis'
Researchers from the Boston University School of Public Health (BUSPH) have written an editorial in the American Journal of Public Health special February issue arguing against the claim that pornography is a public health crisis, and explaining why such a claim actually endangers the health of the public.
The Lancet Public Health: Ageism linked to poorer health in older people in England
Ageism may be linked with poorer health in older people in England, according to an observational study of over 7,500 people aged over 50 published in The Lancet Public Health journal.
Study: Public transportation use linked to better public health
Promoting robust public transportation systems may come with a bonus for public health -- lower obesity rates.
Bloomberg American Health Initiative releases special public health reports supplement
With US life expectancy now on the decline for two consecutive years, the Bloomberg American Health Initiative is releasing a supplement to Public Health Reports, the scholarly journal of the US Surgeon General.
Data does the heavy lifting: Encouraging new public health approaches to promote the health benefits of muscle-strengthening exercise (MSE)
According to a new study in the American Journal of Preventive Medicine, almost 75 percent of US adults do not comply with public health guidelines recommending two or more muscle-strengthening exercise (MSE) sessions a week, with nearly 60 percent of the population doing no MSE at all.
The Lancet Public Health: Moderate carbohydrate intake may be best for health
Low-carb diets that replace carbohydrates with proteins and fats from plant sources associated with lower risk of mortality compared to those that replace carbohydrates with proteins and fat from animal sources.
More Public Health News and Public Health Current Events

Trending Science News

Current Coronavirus (COVID-19) News

Top Science Podcasts

We have hand picked the top science podcasts of 2020.
Now Playing: TED Radio Hour

Listen Again: Meditations on Loneliness
Original broadcast date: April 24, 2020. We're a social species now living in isolation. But loneliness was a problem well before this era of social distancing. This hour, TED speakers explore how we can live and make peace with loneliness. Guests on the show include author and illustrator Jonny Sun, psychologist Susan Pinker, architect Grace Kim, and writer Suleika Jaouad.
Now Playing: Science for the People

#565 The Great Wide Indoors
We're all spending a bit more time indoors this summer than we probably figured. But did you ever stop to think about why the places we live and work as designed the way they are? And how they could be designed better? We're talking with Emily Anthes about her new book "The Great Indoors: The Surprising Science of how Buildings Shape our Behavior, Health and Happiness".
Now Playing: Radiolab

The Third. A TED Talk.
Jad gives a TED talk about his life as a journalist and how Radiolab has evolved over the years. Here's how TED described it:How do you end a story? Host of Radiolab Jad Abumrad tells how his search for an answer led him home to the mountains of Tennessee, where he met an unexpected teacher: Dolly Parton.Jad Nicholas Abumrad is a Lebanese-American radio host, composer and producer. He is the founder of the syndicated public radio program Radiolab, which is broadcast on over 600 radio stations nationwide and is downloaded more than 120 million times a year as a podcast. He also created More Perfect, a podcast that tells the stories behind the Supreme Court's most famous decisions. And most recently, Dolly Parton's America, a nine-episode podcast exploring the life and times of the iconic country music star. Abumrad has received three Peabody Awards and was named a MacArthur Fellow in 2011.