National Healthcare Quality and Disparities Report
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AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 3 of 3 Research Studies DisplayedDy CJ, Salter A, Barker A
Increased utilization of total joint arthroplasty after Medicaid expansion.
This study examined prior analyses that greater utilization of total hip arthroplasty (THA) and total knee arthroplasty (TKA) was to be expected after Medicaid expansion in 2014. Using 2012-2015 data from the HCUP Database, 9 expansion states (Arkansas, Arizona, Colorado, Iowa, Massachusetts, Maryland, Nevada, New York, and Vermont) were compared to 2 states that did not expand Medicaid (Florida and Missouri). After adjusting for community characteristics, THA and TKA increased 15% in 2014 and 23% in 2015 within expansion states compared to 2013. In non-expansion states, compared to 2013, there were significant decreases of 18% in 2014 and 11% in 2015.
AHRQ-funded; HS019455.
Citation: Dy CJ, Salter A, Barker A .
Increased utilization of total joint arthroplasty after Medicaid expansion.
J Bone Joint Surg Am 2021 Mar 17;103(6):524-31. doi: 10.2106/jbjs.20.00303..
Keywords: Healthcare Cost and Utilization Project (HCUP), Medicaid, Orthopedics, Surgery, Healthcare Utilization, Access to Care
Dy CJ, Tipping AD, Nickel KB
Variation in the delivery of inpatient orthopaedic care to Medicaid beneficiaries within a single metropolitan region.
This study examined rates of Medicaid-funded surgical procedures for orthopedic patients. The authors hypothesized that orthopedists and hospitals are often unwilling to perform surgery on underinsured patients. The payer mix was examined for select inpatient orthopedic surgical procedures within a single region, including elective cases (total knee or hip arthroplasty; spinal decompression or fusion) and trauma cases (hip hemiarthroplasty; femoral or tibial or fibular fracture repair) among 22 hospitals from 2011 to 2016 for patients aged 18 to 64 years. For all cases (n = 19,204) the mean percentage of Medicaid-funded surgical procedures was 7.6%. Elective surgery cases were 5.5% and trauma cases 14.7% which supports their beliefs about delivery rates of orthopedic care on the basis of socioeconomic markers.
AHRQ-funded; HS019455.
Citation: Dy CJ, Tipping AD, Nickel KB .
Variation in the delivery of inpatient orthopaedic care to Medicaid beneficiaries within a single metropolitan region.
J Bone Joint Surg Am 2019 Aug 21;101(16):1451-59. doi: 10.2106/jbjs.18.01198.
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Keywords: Orthopedics, Healthcare Delivery, Medicaid, Surgery, Access to Care, Disparities, Health Insurance
Dy CY, Marx RG, Ghomrawi HM
The potential influence of regionalization strategies on delivery of care for elective total joint arthroplasty.
Regionalization of total joint arthroplasty (TJA) to high volume hospitals (HVHs) may affect access to care and complication risk. Using administrative data, the authors found that the complication risk was higher if patients went to a local low volume hospital. Black and Medicaid patients were more likely to utilize the local low volume hospital than a local HVH. Utilizing a local HVH is associated with lower complication risks, but patients from vulnerable groups were less likely to utilize these patterns.
AHRQ-funded; HS016075.
Citation: Dy CY, Marx RG, Ghomrawi HM .
The potential influence of regionalization strategies on delivery of care for elective total joint arthroplasty.
J Arthroplasty 2015 Jan;30(1):1-6. doi: 10.1016/j.arth.2014.08.017.
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Keywords: Access to Care, Disparities, Healthcare Delivery, Orthopedics, Surgery