Study finds Massachusetts health reform leads to increased inpatient surgical procedures

June 13, 2012

Researchers from Boston University Schools of Medicine and Public Health (BUSM, BUSPH), along with the VA Boston Healthcare System and Harvard Medical School, have found inpatient medical procedures increased more among non-elderly, lower- and medium- income populations, Hispanics and whites, after health care reform went into effect in Massachusetts. The findings, which currently appear in Medical Care, suggest improved access to outpatient care for vulnerable subpopulations since health care reform took effect.

The 2006 Massachusetts implementation substantially decreased the number of uninsured in the state. Yet, little is known about the reform's impact on actual among poor and , particularly for inpatient surgical procedures that are commonly initiated by outpatient physician referral.

Researchers used discharge data on Massachusetts hospitalizations for 21 months preceding and following health reform implementation (July 2006–December 2007). They identified all non-obstetrical major therapeutic procedures for patients 40 years and older and for which more than 70 percent of hospitalizations were initiated by an outpatient physician referral. Specifically, they compared pre- and post-reform utilization of major therapeutic inpatient surgical procedures predominantly scheduled by outpatient referrals among non-elderly Massachusetts adults, and found greater overall increases for lower income cohorts compared to the highest income cohort, and for Hispanics compared to whites.

"Prior to reform, both blacks and Hispanics had lower rates of these procedures compared to whites. As 90 percent of all surgeries came from outpatient physician referral, these findings suggest a meaningful improvement in access to for the surgeries studied, especially those living in lower income areas," explained senior author Nancy Kressin, PhD, professor of medicine at BUSM.

Findings of significant post-reform expansion in procedure use for Hispanics and lower area income patients are consistent with the relatively larger gains in insurance coverage among these subpopulations. These findings suggest potentially improved access to outpatient care and may reflect demand built up prior to reform when individuals were uninsured. "Whether such improved access – a crucially important first step to improving equity in access and outcomes – translates into improved clinical outcomes at a reasonable cost merits further study," added Kressin.

Explore further: Massachusetts health-care reform associated with increased demand for medical safety-net facilities

Related Stories

Massachusetts health-care reform associated with increased demand for medical safety-net facilities

August 9, 2011
(Medical Xpress) -- Patient demand for care from safety-net providers (such as community health centers and public hospitals) in Massachusetts has increased, even though the number of patients with health insurance also increased ...

Massachusetts health-care reform increased access to care, particularly among disadvantaged

July 15, 2011
Recent research conducted at Harvard Medical School and the Harvard School of Public Health may have strong implications for informing the controversial debate currently surrounding national health care reform.

Study examines impact of Massachusetts health law on emergency department visits

June 6, 2011
While overall emergency department use in Massachusetts continues to rise, the number of low-severity visits dropped slightly since the implementation of the state's health care reform law, according to an Annals of Emergency ...

Recommended for you

Amber-tinted glasses may provide relief for insomnia

December 15, 2017
How do you unwind before bedtime? If your answer involves Facebook and Netflix, you are actively reducing your chance of a good night's sleep. And you are not alone: 90 percent of Americans use light-emitting electronic devices, ...

Warning labels can help reduce soda consumption and obesity, new study suggests

December 15, 2017
Labels that warn people about the risks of drinking soda and other sugar-sweetened beverages can lower obesity and overweight prevalence, suggests a new Johns Hopkins Bloomberg School of Public Health study.

Office work can be a pain in the neck

December 15, 2017
Neck pain is a common condition among office workers, but regular workplace exercises can prevent and reduce it, a University of Queensland study has found.

Regular takeaways linked to kids' heart disease and diabetes risk factors

December 14, 2017
Kids who regularly eat take-away meals may be boosting their risk factors for heart disease and diabetes, suggests research published online in the Archives of Disease in Childhood.

Your pets can't put your aging on 'paws'

December 14, 2017
(HealthDay)—In a finding that's sure to ruffle some fur and feathers, scientists report that having a pet doesn't fend off age-related declines in physical or mental health.

Simulation model finds Cure Violence program and targeted policing curb urban violence

December 14, 2017
When communities and police work together to deter urban violence, they can achieve better outcomes with fewer resources than when each works in isolation, a simulation model created by researchers at the UC Davis Violence ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.