Neurologic disorders in Medicaid vs privately insured children and working-age adults

Abstract

SummaryThis retrospective, observational study reports health utilization and access patterns of Medicaid recipients for neurologic diseases compared to privately insured individuals seen in 2 hospitals at a single institution in the same time period. We reviewed records of patients and compared demographic characteristics, visit types, neurologic diagnoses, and all-cause mortality, by age group, when seen with Medicaid vs private insurance. Adults insured by Medicaid were more likely to present as inpatients and with life-threatening neurologic disease compared to privately insured patients. Moreover, adult patients presenting with neurologic disease on Medicaid had a higher all-cause mortality rate than privately insured patients. Similar disparities in neurologic disease were not observed in children. The relationship of these findings to patient educational status, household income, comorbidities, and the reasons prompting Medicaid eligibility require additional study. N early 60 million Americans are insured by Medicaid, the nation's largest health insurance program for people of limited income.1 Covered groups include children, pregnant women, and individuals with disabilities. More than one-third of all births and more than one-half of people with AIDS in the United States are covered by Medicaid.

The feasibility of establishing a free clinic for uninsured patients with neurologic disorders

“…According to the American Academy of Neurology (AAN) Task Force, uninsured patients with neurologic disorders have fewer outpatient appointments and receive fewer tests and referrals than insured patients with neurologic disorders. 5 Compared to those with private health insurance, patients with inadequate health insurance coverage are more likely to seek emergency services for chronic neurologic conditions, 6,7 to present with acute life-threatening neurologic conditions, 8 and to experience postacute neurologic care complications. 9,10 Patients without private health insurance also exhibit higher rates of all-cause mortality when they seek emergency services for a neurologic complaint.…”

“…9,10 Patients without private health insurance also exhibit higher rates of all-cause mortality when they seek emergency services for a neurologic complaint. 8 Free medical clinics are one way for the medical community to address insurance-based health care disparities. Although they do not solve the critical problem of health care disparities, these free medical clinics provide temporarily relief for patients who cannot wait for future health care solutions to be developed and implemented.…”