| Title |
Medicaid’s Impact on Chronic Disease Biomarkers: A Cohort Study of Community Health Center Patients
|
|---|---|
| Published in |
Journal of General Internal Medicine, April 2017
|
| DOI | 10.1007/s11606-017-4051-9 |
| Pubmed ID | |
| Authors |
Brigit Hatch, Miguel Marino, Marie Killerby, Heather Angier, Megan Hoopes, Steffani R Bailey, John Heintzman, Jean P O’Malley, Jennifer E DeVoe |
| Abstract |
Understanding the impact of health insurance is critical, particularly in the era of Affordable Care Act Medicaid expansion. The electronic health record (EHR) provides new opportunities to quantify health outcomes. To assess changes in biomarkers of chronic disease among community health center (CHC) patients who gained Medicaid coverage with the Oregon Medicaid expansion (2008-2011). Prospective cohort. Patients were followed for 24 months, and rate of mean biomarker change was calculated. Time to a controlled follow-up measurement was compared using Cox regression models. Using EHR data from OCHIN (a non-profit network of CHCs) linked to state Medicaid data, we identified three cohorts of patients with uncontrolled chronic conditions (diabetes, hypertension, and hyperlipidemia). Within these cohorts, we included patients who gained Medicaid coverage along with a propensity score-matched comparison group who remained uninsured (diabetes n = 608; hypertension n = 1244; hyperlipidemia n = 546). Hemoglobin A1c (HbA1c) for the diabetes cohort, systolic and diastolic blood pressure (SBP and DBP, respectively) for the hypertension cohort, and low-density lipoprotein (LDL) for the hyperlipidemia cohort. All cohorts improved over time. Compared to matched uninsured patients, adults in the diabetes and hypertension cohorts who gained Medicaid coverage were significantly more likely to have a follow-up controlled measurement (hazard ratio [HR] =1.26, p = 0.020; HR = 1.35, p < 0.001, respectively). No significant difference was observed in the hyperlipidemia cohort (HR = 1.09, p = 0.392). OCHIN patients with uncontrolled chronic conditions experienced objective health improvements over time. In two of three chronic disease cohorts, those who gained Medicaid coverage were more likely to achieve a controlled measurement than those who remained uninsured. These findings demonstrate the effective care provided by CHCs and the importance of health insurance coverage within a usual source of care setting. NCT02355132 [ https://clinicaltrials.gov/ct2/show/NCT02355132 ]. |
X Demographics
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Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 1 | 100% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Science communicators (journalists, bloggers, editors) | 1 | 100% |
Mendeley readers
The data shown below were compiled from readership statistics for 43 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 43 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Researcher | 10 | 23% |
| Student > Master | 4 | 9% |
| Student > Bachelor | 3 | 7% |
| Student > Doctoral Student | 2 | 5% |
| Professor > Associate Professor | 2 | 5% |
| Other | 6 | 14% |
| Unknown | 16 | 37% |
| Readers by discipline | Count | As % |
|---|---|---|
| Nursing and Health Professions | 6 | 14% |
| Medicine and Dentistry | 5 | 12% |
| Social Sciences | 3 | 7% |
| Economics, Econometrics and Finance | 2 | 5% |
| Psychology | 1 | 2% |
| Other | 6 | 14% |
| Unknown | 20 | 47% |
Attention Score in Context
This research output has an Altmetric Attention Score of 10. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 10 August 2017.
All research outputs
#3,422,611
of 23,911,072 outputs
Outputs from Journal of General Internal Medicine
#2,466
of 7,806 outputs
Outputs of similar age
#62,734
of 311,774 outputs
Outputs of similar age from Journal of General Internal Medicine
#21
of 87 outputs
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