Ojinnaka Chinedum O, Heflin Colleen
Biomedical Informatics Program, College of Health Solutions, Arizona State University, Phoenix, AZ, USA.
Department of Public Administration and International Affairs, The Maxwell School of Citizenship and Public Affairs, Syracuse University, Syracuse, NY, USA.
J Am Soc Hypertens. 2018 Nov;12(11):e27-e34. doi: 10.1016/j.jash.2018.10.001. Epub 2018 Oct 12.
The Supplemental Nutrition Assistance Program (SNAP) is a public policy program that aims to reduce food insecurity-a social determinant of health that has been associated with suboptimal blood pressure control in the United States. The aim of the article was to explore the association between SNAP benefit timing and size and probability of hypertension-related emergency department (ED) claims. This study used the SNAP data from the Missouri's Department of Social Services for January 2010 to December 2013 linked to Medicaid ED claims data. The dependent variable was probability of hypertension-related and hypertensive emergency ED claims. The independent variables of interest were week of calendar and SNAP benefit months and SNAP benefit amount. Probit regression analyses were conducted. Average marginal effects are reported.In a sample of 6,013,951 Medicaid-insured SNAP beneficiaries, 11,709 hypertension-related claims were submitted for every 100,000 claims. The average marginal effect of SNAP benefit amount on hypertension-related ED claims was -0.0000638 (P < .001); thus, a $100 increase in SNAP benefits will reduce hypertension-related claims by 638 claims per 100,000 claim. The reduction in ED claims was higher for lower SNAP benefit amounts than at higher SNAP benefit amounts. There was no statistically significant association between week of calendar month in which SNAP benefit was received and probability of hypertension-related ED claims. Higher SNAP benefit amount was associated with a decreased probability of hypertension-related ED claims. The impact of an additional dollar of SNAP benefits was larger at lower SNAP benefit amounts.
补充营养援助计划（SNAP）是一项公共政策计划，旨在减少粮食不安全状况——这是一种健康的社会决定因素，在美国已被证明与血压控制不佳有关。本文旨在探讨SNAP福利发放时间和金额与高血压相关急诊科（ED）就诊概率之间的关联。本研究使用了密苏里州社会服务部2010年1月至2013年12月的SNAP数据，并将其与医疗补助ED就诊数据相链接。因变量是高血压相关和高血压急症ED就诊的概率。感兴趣的自变量是日历周、SNAP福利月和SNAP福利金额。进行了概率回归分析，并报告了平均边际效应。在6013951名参加医疗补助的SNAP受益者样本中，每10万份就诊申请中有11709份与高血压相关。SNAP福利金额对高血压相关ED就诊申请的平均边际效应为-0.0000638（P <.001）；因此，SNAP福利每增加100美元，每10万份申请中与高血压相关的申请将减少638份。SNAP福利金额较低时，ED就诊申请的减少幅度高于福利金额较高时。领取SNAP福利的日历周与高血压相关ED就诊概率之间没有统计学上的显著关联。较高的SNAP福利金额与高血压相关ED就诊概率降低相关。在较低的SNAP福利金额下，额外一美元SNAP福利的影响更大。
