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Lapses in Medicaid Coverage

Impact on Cost and Utilization Among Individuals With Diabetes Enrolled in Medicaid

Datos Bibliográficos

ID9100328
AutoresAllyson G Hall (0000-0002-4945-9184, University of Florida Health, autor de correspondencia), Jeffrey S Harman (0000-0002-1125-7704, autor de correspondencia), Jianyi Zhang (0009-0007-4492-9478)
Año2008
Volumen46
Número12
Páginas1219-1225
Fecha de publicación2008-12-01
Peer ReviewedSí
Open AccessNo
TipoARTICLE
RevistaMedical Care (JOURNAL)
Identificadores de la revistaISSN: 0025-7079 • E-ISSN: 1537-1948
EditorialOvid Technologies (Wolters Kluwer Health) (PUBLISHER)
DOI10.1097/mlr.0b013e31817d695c
PMID19300311
OpenAlexW2049188617
IdiomaEN
Citas recibidas10
Referencias citadas24

BACKGROUND: Gaps in Medicaid coverage can result in inadequate access to care. This can be particularly detrimental to those with a chronic disease such as diabetes. OBJECTIVE: To assess whether a lapse in Medicaid coverage is associated with an increase in expenditures, and acute care utilization upon reenrollment among beneficiaries with diabetes. RESEARCH DESIGN: Using multivariate regression analyses, we compared pre- versus post-expenditures and utilization among 2102 individuals with diabetes who had experienced at least one 1-month lapse in their Medicaid coverage. MEASURES: Dependent variables were the number of inpatient episodes, total length of stay, total number of emergency room visits, total expenditure, and pharmaceutical expenditures. These were aggregated over 3-month spans that either immediately preceded or immediately followed a lapse in coverage. Key predictor variables included a variable that identified the span as occurring pre-lapse or post-lapse in coverage, and a continuous variable identifying the length of the lapse. Predicted expenditure and utilization were calculated. RESULTS: Overall total program expenditures were higher for post-lapse periods compared with pre-lapse periods. Total expenditures were estimated to increase by $239 per member per month for the 3-month period. The likelihood of having any expenditure was actually lower in the post-lapse period. However inpatient and emergency room use was higher. CONCLUSIONS: The results from this study suggest that interruptions in Medicaid coverage are associated with overall greater program expenditures in the post-lapse periods. However, this increase in expenditures seems to be driven by a subset of individuals whose greater use of inpatient and emergency room services increased overall program costs

Economic growth · Economics · Health care · Medicaid · MEDLINE · Political science · Healthcare Policy and Management · Healthcare Systems and Reforms · Primary Care and Health Outcomes

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Obras citantes distintas10
Citas por año1
Intervalo de citas2016 - 2025 (10)
Velocidad de citaciónrecent
Altamente citadoNo
Tipos de citaNeutras: 9
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