Insurance-Related Differences in the Risk of Ruptured Appendix

Braveman, Paula; Schaaf, V M; Egerter, Susan; Bennett, Timothy; Schecter, William P.

doi:10.1056/nejm199408183310706

Cited by 204 publications

(180 citation statements)

References 38 publications

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“…Previous work in a less indigent patient population found that Medicaid patients had less access to care than privately insured patients. 29 Other studies have found that patients with Medicaid coverage have greater difficulty finding a regular source of care in the community. 54 In Georgia, Medicaid recipients receive up to five approved prescription medications.…”

Section: Discussionmentioning

confidence: 98%

“…With regard to insurance, many studies have suggested a stepwise differential in access to care, receipt of medical care, and health-related outcomes, with private insurance being better than Medicaid, which in turn is better than no insurance. 25,[29][30][31][32] We conducted a case-control study to examine the effects of predisposing, enabling, and need characteristics of patients on BP control. Our patients were known to be hypertensive and were being treated in an inner-city ambulatory clinic for a range of medical reasons.…”

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confidence: 99%

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Correlates of Controlled Hypertension in Indigent, Inner-City Hypertensive Patients

1997

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OBJECTIVE:To identify correlates of controlled hypertension in a largely minority population of treated hypertensive patients. DESIGN:Case-control study. SETTING: Urban, public hospital.PATIENTS: A consecutive sample of patients who were aware of their diagnosis of hypertension for at least 1 month and had previously filled an antihypertensive prescription. Control patients had a systolic blood pressure (SBP) Յ 140 mm Hg and diastolic blood pressure (DBP) Յ 90 mm Hg, and case patients had a SBP Ն 180 mm Hg or DBP Ն 110 mm Hg. 96; 0.99, 3.88). A secondary analysis found that patients with Medicaid coverage were significantly less likely than the uninsured to report cost as a barrier to purchasing antihypertensive medications and seeing a physician. MEASUREMENTS AND MAIN RESULTS: CONCLUSIONS:The absence of out-of-pocket expenditures under Medicaid for medications and physician care may contribute significantly to BP control. Improved access to a regular source of care and increased sensitivity to medication costs for all patients may lead to improved BP control in an indigent, inner-city population.KEY WORDS: inner-city patients; hypertension; access to care; regular source of care.

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Section: Discussionmentioning

confidence: 98%

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confidence: 99%

Correlates of Controlled Hypertension in Indigent, Inner-City Hypertensive Patients

1997

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“…15 For instance, Weissman et al (1992) find increased hospitalisation for the uninsured for medical conditions that could have been prevented by timely care. Braveman et al (1994) find that the uninsured among appendicitis patients suffer from a higher rate of burst appendix, an outcome that is avoidable with prompt treatment. More recent studies have sought to exploit quasi-random variation in access to Medicare and Medicaid, the two largest public insurance programs in the United States to estimate the causal effects of the lack of insurance on health outcomes (Anderson et al 2012;Card et al 2008Card et al , 2009Dafny and Gruber 2005;Finkelstein 2007).…”

Section: Literature Reviewmentioning

confidence: 91%

Can increased primary care access reduce demand for emergency care? Evidence from England's 7-day GP opening

Dolton

Pathania

2016

Journal of Health Economics

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Restricted access to primary care can lead to avoidable, excessive use of expensive emergency care. Since 2013, partly to alleviate overcrowding at the Accident & Emergency (A&E) units of hospitals, the UK has been piloting 7-day opening of General Practitioner (GP) practices to improve primary care access for patients. We evaluate the impact of these pilots on patient attendances at A&E. We estimate that 7-day GP opening has reduced A&E attendances by patients of pilot practices by 9.9% with most of the impact on weekends which see A&E attendances fall by 17.9%. The effect is non-monotonic in case severity with most of the fall occurring in cases of moderate severity. An additional finding is that there is also a 9.9% fall in weekend hospital admissions (from A&E) which is entirely driven by a fall in admissions of elderly patients. The impact on A&E attendances appears to be bigger among wealthier patients. We present evidence in support of a causal interpretation of our results and discuss policy implications.

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“…Sources: Yelin, Shern, and Epstein 1986;Preston and Retchin 1991;Miller 1992;Retchin et al 1992;Braveman et al 1994;Cole et al 1994;Lurie et al 1994;Riley et al 1994;Shaughnessy, Schlenker, and Hittle 1994;Carey et al 1995;Greenfield et al 1995;O'Toole et al 1996;Ware et al 1996;Yelin, Criswell, and Feigenbaum 1996.…”

Section: Hmos Bettermentioning

confidence: 99%

The Impact of Financial Incentives on Quality of Health Care

et al. 1998

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I n t h e l a s t t w o d e c a d e s t h e f i n a n c i a larrangements in health care have rapidly multiplied and become far more complex. The constant flux in the relations between payors and plans and between plans and providers adds to the difficulty of studying the effect of a specific financial arrangement on the quality of health care provided. Nonetheless, there are good theoretical reasons to believe that financial incentives do have an impact on quality. To address this issue, we briefly describe the difficulty of defining quality and, even with a definition, the problems encountered in measuring it. We then discuss the types of financial incentives that could stimulate quality (however it is measured) and to whom payments that reward quality should be made. Because most available evidence about the impact of financial arrangements on quality is derived from studies that compare health maintenance organizations (HMOs) with fee-for-service (FFS) health plans, we build upon our earlier work and review existing data, heavily flawed though they might be. Given the limitations of these data and the need for a better understanding of the relation be-

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Insurance-Related Differences in the Risk of Ruptured Appendix

Cited by 204 publications

References 38 publications

Correlates of Controlled Hypertension in Indigent, Inner-City Hypertensive Patients

Correlates of Controlled Hypertension in Indigent, Inner-City Hypertensive Patients

Can increased primary care access reduce demand for emergency care? Evidence from England's 7-day GP opening

The Impact of Financial Incentives on Quality of Health Care

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