Emergency Department Utilization in the Texas Medicaid Emergency Waiver

Abstract

Objective: To estimate the enrollment and emergency department (ED) utilization in TexKat, the TexasMedicaid emergency waiver implemented following Hurricane Katrina. Data Sources:Individual-level enrollment and utilization data from the 2005 Medicaid Analytic Extract. Study Design: Descriptive analysis is performed on variables that describe enrollment levels, the demographic characteristics of enrollees, and the most common diagnoses in ED visits. A Poisson regression model is also employed to quantify the factors related to an enrollee's probability of having an ED visit and the average number of ED visits.Principal Findings: There were 44,246 individuals enrolled in TexKat in 2005. Roughly 13% of these enrollees had at least one ED visit during the sample period, with one quarter of these individuals having more than one visit. Across all enrollees the most common diagnosis was "other upper respiratory infection," but there were significant differences in diagnosis patterns across racial/ethnic groups. The regression analysis suggests little difference in ED utilization across genders, but significant contrasts across racial/ethnic and age groups. Conclusions:As very little is known about Medicaid emergency waivers, our analysis may provide important information to policymakers who have to react quickly following a disaster. Our findings may help providers estimate potential increases in ED utilization and prepare for relatively common diagnoses. Furthermore, the analysis across racial/ethnic groups may help government officials identify important areas for outreach among vulnerable populations.

Emergency Department Visits by and Hospitalizations of Senior Diabetics in the Three Years Following Hurricanes Katrina and Rita

“…Nearly all of the research on ED and inpatient utilization following disasters has focused on the period immediately following the event. Hurricane Katrina was associated with immediate increased ED visit rates in both the New Orleans area (Sharma et al 2008) and in Texas (Mortensen et al 2008;Quast et al 2012), while seniors in a Medicare Advantage plan who lived in New Orleans before Katrina were found to have 21% higher ED visits rates during the year after than the year prior to the storm (Burton et al 2009). End stage renal disease patients in affected areas had higher hospitalization rates immediately following Katrina (Anderson et al 2009;Howard et al 2012) while the study of Medicare Advantage plan members found one-year hospitalization rates 23% higher than in the year prior to Katrina (Burton et al 2009).…”

Opportunities and challenges for financing women’s, children’s and adolescents’ health in the context of climate change

“…Financing also favours male-dominated sectors, including energy and transport, whereas female-dominated sectors such as agriculture or textile manufacturing are rarely acknowledged 33. For this reason, social protection support for alternative income sources, including skill development, training and household asset management, should be promoted for women,34 as well as expanding access to formal credit with reduced interest rates 35…”

“… 33 For this reason, social protection support for alternative income sources, including skill development, training and household asset management, should be promoted for women, 34 as well as expanding access to formal credit with reduced interest rates. 35 …”