Show simple item record

dc.contributor.authorLines, Lisa M.
dc.contributor.authorLi, Nien-Chen
dc.contributor.authorMick, Eric O.
dc.contributor.authorAsh, Arlene S.
dc.date2022-08-11T08:10:35.000
dc.date.accessioned2022-08-23T17:13:51Z
dc.date.available2022-08-23T17:13:51Z
dc.date.issued2019-02-01
dc.date.submitted2019-09-18
dc.identifier.citation<p>Med Care. 2019 Feb;57(2):101-108. doi: 10.1097/MLR.0000000000001025. <a href="https://doi.org/10.1097/MLR.0000000000001025">Link to article on publisher's site</a></p>
dc.identifier.issn0025-7079 (Linking)
dc.identifier.doi10.1097/MLR.0000000000001025
dc.identifier.pmid30461581
dc.identifier.urihttp://hdl.handle.net/20.500.14038/46825
dc.description.abstractOBJECTIVE: Conceptually, access to primary care (through insurance) should reduce emergency department (ED) visits for primary care sensitive (PCS) conditions. We sought to identify characteristics of insured Massachusetts residents associated with PCS ED use, and compare such use for public versus private insurees. POPULATION AND SETTING: People under age 65 in the Massachusetts All-Payer Claims Data, 2011-2012. STUDY DESIGN: Retrospective, observational analysis of PCS ED use with nonurgent, urgent/primary care treatable, and urgent/potentially avoidable visits being considered PCS. We predicted utilization in 2012 using multivariable regression models and data available in 2011 administrative records. PRINCIPAL FINDINGS: Among 2,269,475 nonelderly Massachusetts residents, 40% had public insurance. Among public insurees, PCS ED use was higher than for private (mean, 36.5 vs. 9.0 per 100 persons; adjusted risk ratio, 2.53; 95% confidence limits, 2.49-2.56), while having any primary care visit was less common (70% vs. 83%), as was having any visit to one's own (attributed) primary care provider (38% vs. 44%). CONCLUSIONS: Public insurance was associated with less access to primary care and more PCS ED use; statewide labor shortages and low reimbursement rates from public insurance may have provided inadequate access to care that might otherwise have helped reduce PCS ED use.
dc.language.isoen_US
dc.relation<p><a href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&list_uids=30461581&dopt=Abstract">Link to Article in PubMed</a></p>
dc.relation.urlhttps://journals.lww.com/lww-medicalcare/Fulltext/2019/02000/Emergency_Department_and_Primary_Care_Use_in.3.aspx
dc.subjectaccess to care
dc.subjectclaims data
dc.subjectemergency department
dc.subjecthealth insurance
dc.subjectMedicaid
dc.subjectprimary care
dc.subjectquality measurement
dc.subjectrisk adjustment
dc.subjectstate health reform
dc.subjectutilization
dc.subjectEmergency Medicine
dc.subjectEpidemiology
dc.subjectHealth Policy
dc.subjectHealth Services Administration
dc.subjectHealth Services Research
dc.subjectInsurance
dc.subjectPrimary Care
dc.titleEmergency Department and Primary Care Use in Massachusetts 5 Years After Health Reform
dc.typeJournal Article
dc.source.journaltitleMedical care
dc.source.volume57
dc.source.issue2
dc.identifier.legacycoverpagehttps://escholarship.umassmed.edu/qhs_pp/1294
dc.identifier.contextkey15361214
html.description.abstract<p>OBJECTIVE: Conceptually, access to primary care (through insurance) should reduce emergency department (ED) visits for primary care sensitive (PCS) conditions. We sought to identify characteristics of insured Massachusetts residents associated with PCS ED use, and compare such use for public versus private insurees.</p> <p>POPULATION AND SETTING: People under age 65 in the Massachusetts All-Payer Claims Data, 2011-2012.</p> <p>STUDY DESIGN: Retrospective, observational analysis of PCS ED use with nonurgent, urgent/primary care treatable, and urgent/potentially avoidable visits being considered PCS. We predicted utilization in 2012 using multivariable regression models and data available in 2011 administrative records.</p> <p>PRINCIPAL FINDINGS: Among 2,269,475 nonelderly Massachusetts residents, 40% had public insurance. Among public insurees, PCS ED use was higher than for private (mean, 36.5 vs. 9.0 per 100 persons; adjusted risk ratio, 2.53; 95% confidence limits, 2.49-2.56), while having any primary care visit was less common (70% vs. 83%), as was having any visit to one's own (attributed) primary care provider (38% vs. 44%).</p> <p>CONCLUSIONS: Public insurance was associated with less access to primary care and more PCS ED use; statewide labor shortages and low reimbursement rates from public insurance may have provided inadequate access to care that might otherwise have helped reduce PCS ED use.</p>
dc.identifier.submissionpathqhs_pp/1294
dc.contributor.departmentPopulation and Quantitative Health Sciences
dc.contributor.departmentGraduate School of Biomedical Sciences
dc.contributor.departmentUMass Chan Analytics
dc.contributor.departmentBiostatistics and Health Services Research
dc.source.pages101-108


This item appears in the following Collection(s)

Show simple item record