Navigation Links
BUSM study finds increasing health coverage does not improve readmission rates
Date:3/31/2014

BostonIn a first of its kind retrospective study, Boston University School of Medicine (BUSM) researchers have found that providing health insurance coverage to previously uninsured people does not result in reducing 30-day readmission rates. The study, which appears in the British Medical Journal, used data on actual (versus self-reported) use of care and also found no change in racial/ethnic disparities in this outcome, despite a markedly higher baseline of uninsurance among African-American and Hispanics in Massachusetts.

Readmissions have been the focus of health policy interventions to reduce costs with particular focus given to uninsured and minority populations who are at increased risk for frequent readmissions. In March 2010, President Obama signed comprehensive health reform, the Patient Protection and Affordable Care Act, into law. The law established a Hospital Readmissions Reduction Program, which requires the United States Centers for Medicare and Medicaid Services to reduce payments to hospitals with excess readmissions, effective for discharges beginning on October 1, 2012.

Prior studies suggest that when individuals have insurance, they are more likely to have a usual source of care and to utilize medical care, which can prevent unnecessary and costly hospitalizations. However, it is unknown whether expanding health insurance coverage can reduce the risk of readmissions in the overall population, specifically among minority populations.

In order to determine whether readmission rates changed in Massachusetts (which implemented health care reform in 2006) relative to two control states, (New York and New Jersey), which did not enact coverage expansions during the study period, the researchers compared all-payer inpatient discharge databases. Following health reform implementation, Massachusetts individuals experienced a very slight increased risk of 30-day readmissions, relative to similar age individuals in New York and New Jersey.

The researchers also examined whether disparities in readmission rates changed subsequent to reform, hypothesizing that minorities in Massachusetts might stand to benefit the most, as they are at increased risk for readmissions and made the most gains in terms of insurance coverage.

"Among African-Americans and Hispanics, we found the odds of readmission did not decrease in Massachusetts relative to control states, and there was no change in the magnitude of the white-black and white-Hispanic difference in readmission rates," explained lead author Karen Lasser, MD, MPH, an associate professor of medicine at BUSM.

According to the researchers there are several possible explanations for their findings. For example, following health reform in Massachusetts, newly insured individuals were more able to seek medical attention after a hospital admission, which in turn may have uncovered medical problems requiring readmission. Another reason may be the inability to access a personal doctor in the state due to the primary care physician shortage, which has been well documented since 2006.

Other studies in Massachusetts have shown that access to care improved less than access to insurance, as many newly insured residents who obtained Medicaid or state subsidized private insurance still reported cost-related access barriers. "In addition to persistent financial barriers to accessing care (high co-pays, premiums, deductibles and uncovered services) for those with insurance gained under the reform, many providers do not accept these public forms of insurance because of low reimbursement rates," added Lasser.

The researchers believe that in order to reduce readmissions and disparities in readmissions, states in the U.S. like Massachusetts need to go beyond simply expanding insurance coverage.


'/>"/>

Contact: Gina DiGravio
gina.digravio@bmc.org
617-638-8480
Boston University Medical Center
Source:Eurekalert

Related medicine news :

1. Cleveland Clinic study shows bariatric surgery provides long-term control of diabetes
2. Novel study into breast cancer origins paves way for personalized treatment
3. New study confirms benefits of treating heart attack patients with a cheap drug
4. New study finds strong link between obesity and carb breakdown gene
5. Study compares heart valve systems
6. Study estimates proportion of adults affected by new blood pressure guideline
7. Study finds astronauts hearts become more spherical in space
8. Marriage linked to lower heart risks in study of 3.5+ million adults
9. Study shows promise of preserving fertility in boys with cancer
10. Scripps Florida scientist awarded $2.3 million to study dengue fever and related viruses
11. Hormone levels linked to survival of deer calves, study suggests
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:6/23/2017)... ... June 23, 2017 , ... The Rhode Island ... Care Management Alerts and Dashboards, an innovative new service enabling healthcare providers to ... Care Management Alerts and Dashboards provide near real-time data about patients admitted to ...
(Date:6/23/2017)... ... ... Studies show evidence that carotenoids and antioxidants derived either from the diet or ... But how often do ophthalmologists and optometrists in Sweden recommend the use of nutritional ... early symptoms of AMD? A study published recently in Dove Medical Press ...
(Date:6/23/2017)... ... June 23, 2017 , ... Everybody has their own personal preference when it ... it, and some people don't like it at all. FindaTopDoc took a look at ... Erotic literature can give readers a taste of their deepest, darkest fantasies and has ...
(Date:6/23/2017)... ... June 23, 2017 , ... Georgia State University will ... 20. , The two-day conference is focused on advancing scientific knowledge about the ... lives and eliminating racial breast cancer-related disparities. The conference theme is “Illuminating Actionable ...
(Date:6/23/2017)... , ... June 23, 2017 , ... ... Private Flood Insurance offerings. With the Federal Emergency Management Agency’s (FEMA) recent update ... the United States. In 2012, the Biggert-Waters Act was enacted to reflect the ...
Breaking Medicine News(10 mins):
(Date:6/3/2017)... 2017  Eli Lilly and Company (NYSE: ... the Phase 3 MONARCH 2 study showed that ... in combination with fulvestrant, significantly improved progression-free survival ... women with hormone-receptor-positive (HR+), human epidermal growth factor ... relapsed or progressed after endocrine therapy (median PFS, ...
(Date:5/30/2017)... 2017 Therapix Biosciences Ltd. (Nasdaq: TRPX), ... the development of cannabinoid-based drugs, today announced that ... at three upcoming scientific and investor conferences in ... Invitational: ...                     Wednesday, June ...
(Date:5/23/2017)...  Leaf Healthcare, recognized for developing one of ... ulcer prevention, will unveil its comprehensive mobility monitoring ... Nurses, National Teaching Institute and Critical Care Exposition ... Patient Monitoring System is the first mobility monitoring ... system seamlessly tracks patient movement throughout the mobility ...
Breaking Medicine Technology: