Impact of the affordable care act’s medicaid expansion on burn outcomes and disposition

Model System:

Burn

Reference Type:

Journal article

Accession No.:

J87410

Journal:

Burns

Year, Volume, Issue, Page(s):

2021 , 47, 1, 35-41

Publication Website:

Abstract:

Study analyzed the impact of the Affordable Care Act’s Medicaid Expansion on clinical outcomes and patient disposition after burn injury. It was hypothesized that increased insurance coverage results in improved outcomes and higher rates of discharge to inpatient rehabilitation. The study reviewed the University of Washington Regional Burn Center registry data for patients admitted from 2011 to 2018. Patients were grouped into two categories: before (2011–2013) and after (2015−2018) Medicaid expansion; 2014 data was excluded to serve as a washout period. Outcomes assessed included length of hospital stay, patient disposition, and mortality. Multivariable logistic and linear regression models with covariates for sex, age, burn size, ethnicity, distance from burn center, etiology of burn, and presence of inhalation injury were used to determine the impact of Medicaid expansion on outcomes. Results showed that rates of uninsured patients decreased while Medicaid coverage increased. Despite increased median burn size after Medicaid expansion, inpatient mortality rates did not change, but average acute care length of stay increased. More patients were discharged to rehabilitation centers. This study corroborates prior findings of increased insurance coverage since Medicaid expansion. Increased insurance coverage is associated with higher rates of discharge to inpatient rehabilitation programs after burn injury.

Author(s):