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Emergency medicine affordable care act

https://read.qxmd.com/read/34258172/reproductive-healthcare-denials-among-a-privately-insured-population
#21
JOURNAL ARTICLE
Luciana E Hebert, Erin E Wingo, Lee Hasselbacher, Kellie E Schueler, Lori R Freedman, Debra B Stulberg
This study aimed to quantify and examine reproductive healthcare denials experienced by individuals receiving employer-sponsored health insurance. We conducted a national cross-sectional survey using probability and non-probability-based panels from December 2019-January 2020. Eligible respondents were adults employed by any Standard and Poor's 500 company, who received employer-sponsored health insurance. Respondents (n = 1,001) reported whether anyone on their healthcare plan had been denied a reproductive healthcare service in the past five years and details about their denials...
September 2021: Preventive Medicine Reports
https://read.qxmd.com/read/34095898/ethical-issues-in-the-access-to-emergency-care-for-undocumented-immigrants
#22
JOURNAL ARTICLE
Jay M Brenner, Erik Blutinger, Brandon Ricke, Laura Vearrier, Nicholas H Kluesner, John C Moskop
Patients who are undocumented immigrants (UIs) frequently present to emergency departments in the United States, especially in communities with large immigrant populations. Emergency physicians confront important ethical issues when providing care for these patients. This article examines those ethical issues and recommends best practices in emergency care for UIs. After a brief introduction and description of the UI population, the article proposes central principles of emergency medical ethics as a framework for emergency physician decisions and actions...
June 2021: Journal of the American College of Emergency Physicians open
https://read.qxmd.com/read/34011094/effects-of-inadequate-coverage-on-healthcare-utilization-a-regression-discontinuity-analysis
#23
JOURNAL ARTICLE
Jerome A Dugan, Layla G Booshehri
To examine the impact of inadequate health insurance coverage on physician utilization among older adults using a novel quasi-experimental design in the time period following the elimination of cost sharing for most preventative services under the US Affordable Care Act of 2010.The Medical Expenditure Panel Survey full year consolidated data files for the period 2010 to 2017 were used to construct a pooled cross-sectional dataset of adults aged 60 to 70. Regression discontinuity design was used to estimate the impact of transitioning between non-Medicare and Medicare plans on use of routine office-based physician visits and emergency room visits...
May 21, 2021: Medicine (Baltimore)
https://read.qxmd.com/read/33992655/increasing-inclusivity-in-patient-centered-research-begins-with-language
#24
JOURNAL ARTICLE
Alexa M Curt, Mia M Kanak, Eric W Fleegler, Amanda M Stewart
Emergency departments frequently serve marginalized populations. Spanish-speaking families who come to the ED often have high rates of unmet social needs. Our study investigated how to efficiently screen families for unmet social needs in an emergency department. Participants who screened positive for needs were referred to geographically convenient, community-based resources. It became clear that barriers related to language discordance existed for recruiting Spanish-speaking participants that were not present for English-speaking participants which we believe exacerbate existing inequities and must be addressed...
May 13, 2021: Preventive Medicine
https://read.qxmd.com/read/33964693/the-effect-of-expanded-insurance-coverage-under-the-affordable-care-act-on-emergency-department-utilization-in-new-york
#25
JOURNAL ARTICLE
Theodoros V Giannouchos, Hye-Chung Kum, Jodie C Gary, Michael A Morrisey, Robert L Ohsfeldt
BACKGROUND: One of the proposed benefits of expanding insurance coverage under the Affordable Care Act (ACA) was a reduction in emergency department (ED) utilization for non-urgent visits related to lack of health insurance coverage and access to primary care providers. The objective of this study was to estimate the effect of the 2014 ACA implementation on ED use in New York. METHODS: We used the Healthcare Cost and Utilization Project State Emergency Department and State Inpatient Databases for all outpatient and all inpatient visits for patients admitted through an ED from 2011 to 2016...
October 2021: American Journal of Emergency Medicine
https://read.qxmd.com/read/33840510/emergency-department-and-ambulatory-care-visits-in-the-first-twelve-months-of-coverage-under-medicaid-expansion-a-group-based-trajectory-analysis
#26
JOURNAL ARTICLE
Mara A G Hollander, Evan S Cole, Lindsay M Sabik, Jeremy M Kahn, Chung-Chou H Chang, Marian P Jarlenski, Julie M Donohue
STUDY OBJECTIVE: More than 17 million people have gained health insurance coverage through the Patient Protection and Affordable Care Act's Medicaid expansion. Few studies have examined heterogeneity within the Medicaid expansion population. We do so based on time-varying patterns of emergency department (ED) and ambulatory care use, and characterize diagnoses associated with ED and ambulatory care visits to evaluate whether certain diagnoses predominate in individual trajectories. METHOD: We used group-based multitrajectory modeling to jointly estimate trajectories of ambulatory care and ED utilization in the first 12 months of enrollment among Pennsylvania Medicaid expansion enrollees from 2015 to 2017...
April 8, 2021: Annals of Emergency Medicine
https://read.qxmd.com/read/33812329/racial-ethnic-disparities-in-emergency-department-wait-times-in-the-united-states-2013-2017
#27
JOURNAL ARTICLE
Frederick Q Lu, Amresh D Hanchate, Michael K Paasche-Orlow
BACKGROUND: Previous research shows that Black and Hispanic patients have longer ED wait times than White patients, but these data do not reflect recent changes such as the Affordable Care Act. In addition, previous research does not account for the non-normal distribution of wait times, wherein a sizable subgroup of patients seen promptly and those not seen promptly experience long wait times. METHODS: We utilized National Hospital Ambulatory Medical Care Survey (NHAMCS) datasets (2013-2017) to examine mean ED wait time comparing visits by Black, Hispanic, and Asian patients to White patients...
March 26, 2021: American Journal of Emergency Medicine
https://read.qxmd.com/read/33337495/association-of-the-national-dependent-coverage-expansion-with-insurance-use-for-sexual-and-reproductive-health-services-by-female-young-adults
#28
JOURNAL ARTICLE
Jacqueline E Ellison, Amresh D Hanchate, Lewis E Kazis, Megan B Cole
Importance: Sexual and reproductive health services are a primary reason for care seeking by female young adults, but the association of the 2010 Patient Protection and Affordable Care Act Dependent Coverage Expansion (ACA-DCE) with insurance use for these services has not been studied to our knowledge. Insurer billing practices may compromise dependent confidentiality, potentially discouraging dependents from using insurance or obtaining care. Objective: To evaluate the association between implementation of ACA-DCE and insurance use for confidential sexual and reproductive health services by female young adults newly eligible for parental coverage...
December 1, 2020: JAMA Network Open
https://read.qxmd.com/read/33228623/the-influence-of-healthcare-financing-on-cardiovascular-disease-prevention-in-people-living-with-hiv
#29
JOURNAL ARTICLE
Allison R Webel, Julie Schexnayder, C Robin Rentrope, Hayden B Bosworth, Corrilynn O Hileman, Nwora Lance Okeke, Rajesh Vedanthan, Chris T Longenecker
BACKGROUND: People living with HIV are diagnosed with age-related chronic health conditions, including cardiovascular disease, at higher than expected rates. Medical management of these chronic health conditions frequently occur in HIV specialty clinics by providers trained in general internal medicine, family medicine, or infectious disease. In recent years, changes in the healthcare financing for people living with HIV in the U.S. has been dynamic due to changes in the Affordable Care Act...
November 23, 2020: BMC Public Health
https://read.qxmd.com/read/33196808/association-between-state-medicaid-expansion-and-emergency-access-to-acute-care-hospitals-in-the-united-states
#30
JOURNAL ARTICLE
David J Wallace, Julie M Donohue, Derek C Angus, Lindsay M Sabik, Billie Davis, Jonathan Yabes, Jeremy M Kahn
Importance: State decisions not to expand Medicaid under the Patient Protection and Affordable Care Act could reduce emergency access to acute care hospitals. Objective: To determine the relationship between state Medicaid expansion and emergency access to acute care hospitals in the United States. Design, Setting, and Participants: This cross-sectional study linked hospital-level data from the Centers for Medicare & Medicaid Services from 2007 to 2017 to US Census data for all 50 US states and the District of Columbia...
November 2, 2020: JAMA Network Open
https://read.qxmd.com/read/33175178/association-of-affordable-care-act-implementation-with-ambulance-utilization-for-asthma-emergencies-in-new-york-city-2008-2018
#31
JOURNAL ARTICLE
Gregory A Peters, Alexander J Ordoobadi, Rebecca E Cash, Matthew L Wong, Paul Avillach, Carlos A Camargo
Importance: Emergency medical services (EMS) are an essential component of the health care system, but the effect of insurance expansion on EMS call volume remains unclear. Objective: This study investigated the association between health insurance expansion and EMS dispatches for asthma, an ambulatory care-sensitive condition. We hypothesized that insurance expansion under the Patient Protection and Affordable Care Act (ACA) would be associated with decreased EMS dispatches for asthma emergencies...
November 2, 2020: JAMA Network Open
https://read.qxmd.com/read/32856171/harmony-or-dissonance-the-affordances-of-palliative-care-learning-for-emerging-professional-identity
#32
JOURNAL ARTICLE
Frances Kilbertus, Rola Ajjawi, Douglas Archibald
INTRODUCTION: Patient demographics demand physicians who are competent in and embrace palliative care as part of their professional identity. Published literature describes ways that learners acquire knowledge, skills and attitudes for palliative care. These studies are, however, limited by their focus on the individual where learning is about acquisition. Viewing learning as a process of becoming through the interplay of individual, social relationships and cultures, offers a novel perspective from which to explore the affordances for professional identity development...
August 27, 2020: Perspectives on Medical Education
https://read.qxmd.com/read/32854964/the-three-year-effect-of-medicaid-expansion-on-emergency-department-visits-and-admissions
#33
JOURNAL ARTICLE
Ali Moghtaderi, Bernard Black, Mark Zocchi, Kevin Klauer, Randy Pilgrim, Jesse M Pines
STUDY OBJECTIVE: We examine the effect of the Medicaid expansion in 2014 under in the Patient Protection and Affordable Care Act on emergency department (ED) utilization and ED admission rates (fraction of ED visits that lead to hospital admission) during the first 3 postexpansion years (2014 to 2016). METHODS: We compared ED utilization and ED admission rates in 151 EDs in 14 expansion states with those in 376 EDs in 14 nonexpansion states, using difference-in-differences methods with data from 3 national emergency medicine groups from 2013 to 2016...
January 2021: Annals of Emergency Medicine
https://read.qxmd.com/read/32782900/impact-of-insurance-and-practice-type-on-access-to-orthopaedic-sports-medicine
#34
JOURNAL ARTICLE
Weilong Shi, Albert Anastasio, Ndeye F Guisse, Razan Faraj, Omolola P Fakunle, Kirk Easley, Kyle E Hammond
Background: The Patient Protection Affordable Care Act has expanded Medicaid eligibility in recent years. However, the provisions of the act have not translated to improved Medicaid payments for specialists such as orthopaedic surgeons. The number of health care practitioners who accept Medicaid is already decreasing, with low reimbursement rates being cited as the primary reason for the trend. Hypothesis: Private practice orthopaedic groups will see patients with Medicaid or Medicare at lower rates than academic orthopaedic practices, and business days until appointment availability will be higher for patients with Medicaid and Medicare than those with private insurance...
July 2020: Orthopaedic Journal of Sports Medicine
https://read.qxmd.com/read/31132912/the-effect-of-medicaid-expansion-on-the-nature-of-new-enrollees-emergency-department-use
#35
JOURNAL ARTICLE
Rahul Ladhania, Amelia M Haviland, Arvind Venkat, Rahul Telang, Jesse M Pines
We examine changes in emergency department (ED) visit acuity and care intensity for uninsured patients who gained Medicaid insurance in 2014 under the Patient Protection and Affordable Care Act. We use 2013-2015 longitudinal patient visit-level data from 30 EDs across 7 states from an emergency medicine group. We examine changes in ED use by previously uninsured Medicaid patients and patients remaining uninsured who were repeat ED users (≥1 visit before and after expansion) using a propensity-score weighted approach with statistical machine learning to estimate the weights...
May 27, 2019: Medical Care Research and Review: MCRR
https://read.qxmd.com/read/30531050/gibson-s-theory-of-affordances-and-situational-awareness-occurring-in-urban-departments-of-pediatrics-medicine-and-emergency-medicine
#36
JOURNAL ARTICLE
Timothy C Clapper, Joanna Lee, Jeffrey Phillips, Kapil Rajwani, Neel Naik, Kevin Ching
Background: The Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS® ) program provides a situation-monitoring tool that allows health-care professionals to perform an environmental scan. This process includes scanning the status of the patient, team members, and the environment, to ensure that patient care is progressing toward the goal. It is assumed that health-care professionals will act in a certain way by providing feedback and support based on the scan...
May 2018: Education for Health
https://read.qxmd.com/read/30470515/changes-in-reimbursement-to-emergency-physicians-after-medicaid-expansion-under-the-patient-protection-and-affordable-care-act
#37
JOURNAL ARTICLE
Jesse M Pines, Rahul Ladhania, Bernard S Black, Christopher K Corbit, Jestin N Carlson, Arvind Venkat
STUDY OBJECTIVE: We examine the effect of Medicaid expansion on reimbursement for emergency physicians' professional services. METHODS: We conducted a retrospective study using data from a national emergency medicine group in a sample of 50 emergency departments (EDs) from July 1, 2012, to June 30, 2015. We categorized facilities in 14 states into full-expansion (23), partial-expansion (17), and nonexpansion (10) categories based on pre-expansion Medicaid eligibility criteria for all adults...
November 20, 2018: Annals of Emergency Medicine
https://read.qxmd.com/read/30311228/how-do-we-fund-flourishing-maybe-not-through-health-care
#38
JOURNAL ARTICLE
Lauren A Taylor
The health policy community has a growing interest in the impact of nonmedical determinants of health, such as housing, nutrition, and social supports, on both health outcomes and costs. This interest has been spurred by the Affordable Care Act's emphasis on prevention, Robert Wood Johnson's grant-making focus on a Culture of Health, and an uptick of research demonstrating the potential returns to health care from investments in social services. Much of this policy-making, grant making, and research has focused on older Americans...
September 2018: Hastings Center Report
https://read.qxmd.com/read/29761755/a-deadly-wait-for-u-s-health-insurance-coverage-sitting-on-the-couch-with-malaria
#39
JOURNAL ARTICLE
Jonathan S Schultz, Adam J Atherly, Andrés F Henao-Martínez
Uninsured and unprepared travelers to countries with endemic tropical diseases pose great health-care burdens and financial risks on returning to the United States. We discuss the delayed presentation of an uninsured U.S. traveler returning from West Africa with severe malaria who required intensive care measures to save his life. Despite being critically ill on his return, he sat rigoring on his couch taking antipyretics for 3 days, while he applied for insurance on the Affordable Care Act website and waited for approval because he was fearful of the costs of seeking care...
July 2018: American Journal of Tropical Medicine and Hygiene
https://read.qxmd.com/read/28800938/using-hospital-use-trends-to-improve-transitional-care
#40
JOURNAL ARTICLE
Joe Feinglass, Celeste A Mallama, Angela Rogers, Caroline Teter, Courtney Hurt, Christine Schaeffer
BACKGROUND: This study evaluates the Northwestern Medicine Group Transitional Care clinic (NMG-TC), which transitions patients from an urban hospital to primary care at partner community clinics. We evaluate change over the 55 month study period in emergency department, observation or inpatient use within 90 days of an initial NMG-TC visit. METHODS: Electronic health records were used to determine patient demographic, insurance and clinical characteristics, including inflation-adjusted total hospital charges in the 90 days prior and the 90 days after an initial NMG-TC visit...
August 8, 2017: Healthcare
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