Medicaid Expansion and Mechanical Ventilation in Asthma, Chronic Obstructive Pulmonary Disease, and Heart Failure

Annals of the American Thoracic Society
Andrew J AdmonColin R Cooke

Abstract

Rationale: The Affordable Care Act's Medicaid expansion has led to increased access to chronic disease care among newly insured adults. Despite this, its effects on clinical outcomes, particularly for patients with asthma, chronic obstructive pulmonary disease, and heart failure, are uncertain. Objectives: To assess whether Medicaid expansion was associated with changes in mechanical ventilation rates among hospitalized patients with heart failure, asthma, and chronic obstructive pulmonary disease. Methods: Difference-in-differences analysis comparing discharge data from four states that expanded Medicaid in 2014 (Arizona, Iowa, New Jersey, and Washington) and three comparison states that did not (North Carolina, Nebraska, and Wisconsin) was performed. Models were adjusted for patient and hospital factors. Results: Mechanical ventilation rates at baseline were 7.2% in nonexpansion states and 8.8% in expansion states. Medicaid expansion was associated with a decline in mechanical ventilation rates at -0.2% per quarter (95% confidence interval [CI], -0.3% to 0.0%; P = 0.010). We did not observe a change in the rate of ICU admission (-0.4% per quarter; 95% CI, -0.8% to 0.1%; P = 0.10) or in-hospital mortality (0.1% per quarter; 95...Continue Reading

References

Feb 7, 1998·Medical Care·A ElixhauserR M Coffey
Dec 27, 2007·JAMA : the Journal of the American Medical Association·J Michael McWilliamsJohn Z Ayanian
Dec 17, 2008·Annals of Internal Medicine·Andrew B BindmanGlenna M Auerback
Jul 20, 2010·Critical Care Medicine·Hannah WunschJeremy M Kahn
May 9, 2012·Critical Care Medicine·Hayley B GershengornHannah Wunsch
Sep 19, 2012·Health Services Research·Christopher W SeymourColin R Cooke
Jun 12, 2013·Journal of the American College of Cardiology·Clyde W YancyUNKNOWN American Heart Association Task Force on Practice Guidelines
Dec 18, 2013·The European Respiratory Journal·Kian Fan ChungW Gerald Teague
Jan 11, 2014·JAMA : the Journal of the American Medical Association·Rebecca A Gooch, Jeremy M Kahn
Jul 6, 2014·JAMA Surgery·Chandy EllimoottilDavid C Miller
Dec 10, 2014·JAMA : the Journal of the American Medical Association·Justin B Dimick, Andrew M Ryan
Sep 24, 2015·BMJ : British Medical Journal·Philip Sedgwick
Aug 16, 2016·Critical Care Medicine·Andrew J AdmonColin R Cooke
Nov 16, 2016·Respiratory Research·Nicolas MolinariArnaud Bourdin
Dec 16, 2016·American Journal of Respiratory and Critical Care Medicine·Meeta Prasad KerlinScott D Halpern
Mar 17, 2017·The European Respiratory Journal·Jadwiga A WedzichaJerry A Krishnan
Apr 6, 2017·Journal of Policy Analysis and Management : [the Journal of the Association for Public Policy Analysis and Management]·Kosali SimonJohn Cawley
May 4, 2017·The New England Journal of Medicine·Benjamin D Sommers, Kosali Simon
Jul 1, 2017·Health Services Research·Gary PickensHerbert S Wong
Aug 13, 2017·Chest·Craig M LillyOmar Badawi
Jan 9, 2018·Health Affairs·Richard C LindroothGregory J Tung
Jun 5, 2018·Health Affairs·Olena MazurenkoNir Menachemi
Jun 23, 2018·Journal of Critical Care·Jonathan D BaghdadiDaniel Z Uslan
Aug 7, 2018·Health Affairs·Rebecca MyersonElbert S Huang

❮ Previous
Next ❯

Citations

Aug 2, 2019·Annals of the American Thoracic Society·Samuel M Brown, Robert Paine
Jul 2, 2019·Annals of the American Thoracic Society·J Daryl Thornton
Jan 1, 2020·Annals of the American Thoracic Society·Andrew J Admon
Oct 5, 2019·Annals of the American Thoracic Society·Gary E WeissmanScott D Halpern
Mar 17, 2020·American Journal of Respiratory and Critical Care Medicine·Yaseen M ArabiHasan M Al-Dorzi
Jul 31, 2020·The Journal of Asthma : Official Journal of the Association for the Care of Asthma·Joy HsuW Dana Flanders
Apr 28, 2020·American Journal of Respiratory and Critical Care Medicine·Sejal SaglaniAdnan Custovic

❮ Previous
Next ❯

Software Mentioned

Stata
SAS

Related Concepts

Related Feeds

Asthma

This feed focuses in Asthma in which your airways narrow and swell. This can make breathing difficult and trigger coughing, wheezing and shortness of breath.

Allergy and Asthma

Allergy and asthma are inflammatory disorders that are triggered by the activation of an allergen-specific regulatory t cell. These t cells become activated when allergens are recognized by allergen-presenting cells. Here is the latest research on allergy and asthma.

American Thoracic Association Journals

Discover the latest respiratory research published by the journals from the American Thoracic Society.