The University of Illinois at Chicago, USA.
Indiana University Bloomington, USA.
J Aging Health. 2019 Dec;31(10_suppl):97S-123S. doi: 10.1177/0898264318808192. Epub 2018 Nov 15.
We evaluated the impact of Medicaid managed care (MMC) on health service use and state costs among adults with early-acquired physical disabilities. Using claims data, we tracked utilization of the emergency department (ED), inpatient admissions, outpatient physician visits, and state expenditures on enrollees who transitioned to MMC ( = 881). The inverse propensity score weight and a difference-in-differences regression model were used to estimate the impact of MMC using their counterparts who remained in fee-for-service ( = 1,552) as the comparison group. MMC reduced ED use by 3.2% points/month ( < .001). Relative to younger enrollees (age ⩽45 years), MMC reduced inpatient admissions of older enrollees (age ⩾46 years) by 3.3% points/month ( < .001), and state expenditures by US$839/month ( < .01). MMC could reduce the hospital service use of and state spending on enrollees with early-acquired physical disabilities. This impact may vary depending on the enrollees' age.
我们评估了医疗补助管理式医疗(MMC)对有早期获得性身体残疾的成年人的卫生服务使用和州级成本的影响。我们使用索赔数据,追踪了向 MMC 过渡的参保人的急诊部门(ED)使用情况、住院入院、门诊医生就诊和州级支出(n=881)。我们使用反倾向得分权重和差异中的差异回归模型,将继续接受按服务收费(FFS)的参保人(n=1552)作为对照组,来估算 MMC 的影响。MMC 使 ED 使用量每月减少 3.2%(<0.001)。与年轻的参保人(年龄⩽45 岁)相比,MMC 使年龄较大的参保人(年龄⩾46 岁)的住院入院量每月减少 3.3%(<0.001),州级支出每月减少 839 美元(<0.01)。MMC 可以减少有早期获得性身体残疾的参保人的医院服务使用和州级支出。这种影响可能因参保人的年龄而异。