Access to post-acute care services reduces emergency department utilisation among individuals insured by Medicaid: An observational study.
Heather Brom, Colleen V Anusiewicz, Idorenyin Udoeyo and 2 others
PMID 34240494WHAT IT FOUND
Medicaid patients discharged from a safety-net hospital had more emergency visits within 30 days.
Home health and specialty care were associated with fewer emergency visits, and when specialty care was included, the Medicaid gap was no longer seen.
Key findings
01Patients insured by Medicaid had emergency visits within 30 days more often than commercially insured patients (12.4% vs 4.2%; p < .001).
02Use of home care and specialty care was associated with statistically significant lower odds of an emergency visit.
03After specialty care use was accounted for, the association between Medicaid insurance and emergency visits was no longer statistically significant (OR 1.92, 95% CI: 0.92-4.00).
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
Read the rest of this summary
You get three full summaries a month, free, and we do not ask for a card. Search, the TL;DRs and your library stay unlimited either way.
What it does not show
The study used records from one urban safety-net health system, so it may not apply to other hospitals or regions. Electronic records captured only care within that health system, so emergency visits or post-acute services obtained elsewhere may have been missed. The analysis could not include social needs described only in narrative notes. AIDS/HIV, alcohol abuse, drug abuse, and psychoses comorbidities were not included because they were omitted from the data. This was an observational study, so it shows associations rather than proof that specialty care or home health reduced emergency visits. Adults aged 65 and older and Medicare-insured patients were excluded, so it says nothing about those groups.
Declared interests
The authors declared no conflicts of interest. No funding statement is provided.
The easy way to misread this
Do not conclude that referring Medicaid patients to specialty care or home health will reduce their emergency visits. This was an observational study of records from one health system, so it shows associations, not proof that the services caused fewer visits.