University of Kentucky Department of Surgery, 780 Rose Street, Lexington, KY, 40536, USA.
University of Kentucky Department of Biostatistics, 111 Washington Ave, Lexington, KY, 40536, USA.
Am J Surg. 2024 Jun;232:102-106. doi: 10.1016/j.amjsurg.2024.01.015. Epub 2024 Jan 18.
Kentucky was among the first to adopt Medicaid expansion, resulting in reducing uninsured rates from 14.3% to 6.4%. We hypothesize that Medicaid expansion resulted in increased elective healthcare utilization and reductions in emergency treatments by patients suffering Inflammatory Bowel Disease (IBD).
The Hospital Inpatient Discharge and Outpatient Services Database (HIDOSD) identified all encounters related to IBD from 2009 to 2020 in Kentucky. Several demographic variables were compared in pre- and post-Medicaid expansion adoption.
Our study analyzed 3386 pre-expansion and 24,255 post-expansion encounters for IBD patients. Results showed that hospitalization rates dropped (47.7%-8.4%), outpatient visits increased (52.3%-91.6%) and Emergency visits decreased (36.7%-11.4%). Admission following a clinical referral similarly increased with a corresponding drop in emergency room admissions. Hospital costs and lengths of stay also dropped following Medicaid expansion.
In the IBD population, Medicaid expansion improved access to preventative care, reduced hospital costs by decreasing emergency care, and increased elective care pathways.
肯塔基州是最早实施医疗补助计划扩大的州之一，这使得该州的无保险率从 14.3%降至 6.4%。我们假设医疗补助计划扩大导致患有炎症性肠病（IBD）的患者增加了择期医疗服务的利用率，并减少了急诊治疗。
医院住院和门诊服务数据库（HIDOSD）从 2009 年到 2020 年在肯塔基州确定了所有与 IBD 相关的就诊。在医疗补助计划扩大实施前后比较了几个人口统计学变量。
我们的研究分析了 3386 例扩张前和 24255 例扩张后 IBD 患者的就诊情况。结果表明，住院率下降（47.7%-8.4%），门诊就诊增加（52.3%-91.6%），急诊就诊减少（36.7%-11.4%）。在临床转诊后，住院率也有所增加，同时急诊入院率相应下降。医疗补助计划扩大后，医院的成本和住院时间也有所下降。
在 IBD 患者中，医疗补助计划扩大改善了预防保健的可及性，通过减少急诊治疗降低了医院成本，并增加了择期治疗途径。
