Dataset Information

Intra-Ethnic Coverage Disparities among Latinos and the Effects of Health Reform.

ABSTRACT:

Objective

To examine the patterns of insurance coverage among nine Latino subgroups and assess heterogeneous effects of the Affordable Care Act (ACA) among these groups.

Data sources

American Community Survey (2010-2014).

Study design

We examined pre-ACA disparities in coverage using linear probability models. Then, we used interrupted time series and triple-difference models to evaluate coverage changes associated with the ACA and Medicaid expansion, respectively.

Principal findings

Pre-ACA coverage disparities between Latino subgroups were nearly 30 percentage points-larger than the gap between whites and Latinos as a whole. Coverage changes associated with the ACA and Medicaid expansion differed significantly between subgroups, with the largest gains among South Americans, Central Americans, and Mexicans.

Conclusions

Latino subgroups show marked heterogeneity in baseline coverage rates and responses to the ACA.

SUBMITTER: Gonzales S

PROVIDER: S-EPMC5980375 | biostudies-literature | 2018 Jun

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Intra-Ethnic Coverage Disparities among Latinos and the Effects of Health Reform.

Gonzales Sergio S Sommers Benjamin D BD

Health services research 20170628 3

<h4>Objective</h4>To examine the patterns of insurance coverage among nine Latino subgroups and assess heterogeneous effects of the Affordable Care Act (ACA) among these groups.<h4>Data sources</h4>American Community Survey (2010-2014).<h4>Study design</h4>We examined pre-ACA disparities in coverage using linear probability models. Then, we used interrupted time series and triple-difference models to evaluate coverage changes associated with the ACA and Medicaid expansion, respectively.<h4>Princ ...[more]

PMID: 28660697

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Project description:ImportanceRacial disparities in receipt of minimally invasive surgery (MIS) persist in the United States and have been shown to also be associated with a number of driving factors, including insurance status. However, little is known as to how expanding insurance coverage across a population influences disparities in surgical care.ObjectiveTo evaluate the impact of Massachusetts health care reform on racial disparities in MIS.Design, setting, and participantsA retrospective cohort study assessed the probability of undergoing MIS vs an open operation for nonwhite patients in Massachusetts compared with 6 control states. All discharges (n = 167,560) of nonelderly white, black, or Latino patients with government insurance (Medicaid or Commonwealth Care insurance) or no insurance who underwent a procedure for acute appendicitis or acute cholecystitis at inpatient hospitals between January 1, 2001, and December 31, 2009, were assessed. Data are from the Hospital Cost and Utilization Project State Inpatient Databases.InterventionThe 2006 Massachusetts health care reform, which expanded insurance coverage for government-subsidized, self-pay, and uninsured individuals in Massachusetts.Main outcomes and measuresAdjusted probability of undergoing MIS and difference-in-difference estimates.ResultsPrior to the 2006 reform, Massachusetts nonwhite patients had a 5.21-percentage point lower probability of MIS relative to white patients (P < .001). Nonwhite patients in control states had a 1.39-percentage point lower probability of MIS (P = .007). After reform, nonwhite patients in Massachusetts had a 3.71-percentage point increase in the probability of MIS relative to concurrent trends in control states (P = .01). After 2006, measured racial disparities in MIS resolved in Massachusetts, with nonwhite patients having equal probability of MIS relative to white patients (0.06 percentage point greater; P = .96). However, nonwhite patients in control states without health care reform have a persistently lower probability of MIS relative to white patients (3.19 percentage points lower; P < .001).Conclusions and relevanceThe 2006 Massachusetts insurance expansion was associated with an increased probability of nonwhite patients undergoing MIS and resolution of measured racial disparities in MIS.

Dataset Information

Intra-Ethnic Coverage Disparities among Latinos and the Effects of Health Reform.

Objective

Data sources

Study design

Principal findings

Conclusions

Publications

Intra-Ethnic Coverage Disparities among Latinos and the Effects of Health Reform.

Similar Datasets

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