insurance policy papers

What is the study about?

This study examined the impact of the Washington State Affordable Care Act’s (ACA) Medicaid expansion on patient disposition (i.e., home vs. inpatient rehabilitation), mortality (i.e., death), and length of hospital stay after burn injury. For severe burns, inpatient rehabilitation after hospitalization improves functional outcomes. However, studies have found that people without health insurance are less likely to be discharged to rehabilitation after burn injury, and have a shorter length of stay compared to those with private insurance. The researchers hypothesized that increased insurance coverage would result in improved outcomes, including higher rates of discharge to inpatient rehabilitation.

What did the study find?

The findings from this study support previous research findings on how increased insurance coverage is linked to higher rates of discharge to inpatient rehabilitation programs after burn injury. Additionally, the researchers found the average acute care length of stay increased.

Who participated in the study?

The study included 4,098 burn survivors (2,091 prior to the ACA Medicaid expansion employed, and 2,007 after the ACA Medicaid expansion).

How was the study conducted?

Researchers reviewed the University of Washington’ Regional Burn Center registry data for patients admitted from 2011 to 2018. Patients were grouped into two categories: before (2011-2012) and after (2015-2018) Medicaid expansion to assess impact of the Medicaid expansion. Data from 2014 were not included.

How can people use the results?

Burn survivors and their families can use these results to better understand the importance of insurance coverage and its impact on inpatient rehabilitation and long-term outcomes for burn survivors. Researchers and clinicians can use these results to further explore factors that mediate burn survivors’ ability to access inpatient rehabilitation care and clinical outcomes.


Oh, J., Fernando, A., Sibbett, S., Carrougher, G. J., Stewart, B. T., Mandell, S. P., Pham, T. N., & Gibran, N. S. (2021). Impact of the Affordable Care Act’s Medicaid expansion on burn outcomes and disposition. Burns, 47, 35-41. []


The contents of this quick review were developed under a grant from the National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR grant numbers 90DPKT0009 and #90DPBU0004,). NIDILRR is a Center within the Administration for Community Living (ACL), Department of Health and Human Services (HHS). The contents of this quick review do not necessarily represent the policy of NIDILRR, ACL, HHS, and you should not assume endorsement by the Federal Government.