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Early Impact of the Patient Protection and Affordable Care Act on Delivery of Children's Surgical Care.

Publication ,  Journal Article
Routh, JC; Wolf, S; Tejwani, R; Jiang, R; Pomann, G-M; Goldstein, BA; Maciejewski, ML; Allori, AC
Published in: Clin Pediatr (Phila)
April 2019

The impact of the Patient Protection and Affordable Care Act (PPACA) on children's access to surgical care is not well-defined. Our objective was to describe the early impact of PPACA on children's surgical care before and after Medicaid expansion in 2014. We compared pediatric and young adult surgical outcomes in 2013 and 2014 in Medicaid expansion and nonexpansion states; young adults were included as a control group. From 4 states, 1 597 708 encounters met all inclusion criteria. Comparing expansion to nonexpansion states, modest increases were noted in elective instead of urgent/emergent admissions; in ambulatory instead of inpatient surgeries; in inpatient length of stays; in discharges to home instead of other inpatient care facilities; and in charges for inpatient admissions. A modest decrease of -1.1% was noted in ambulatory admission charges. Overall, we conclude that Medicaid expansion likely increased children's access to surgical care, resulting in improved delivery and slightly reduced charges.

Duke Scholars

Published In

Clin Pediatr (Phila)

DOI

EISSN

1938-2707

Publication Date

April 2019

Volume

58

Issue

4

Start / End Page

453 / 460

Location

United States

Related Subject Headings

  • Young Adult
  • United States
  • Surgical Procedures, Operative
  • Pediatrics
  • Patient Protection and Affordable Care Act
  • Medicaid
  • Male
  • Infant, Newborn
  • Infant
  • Humans
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Routh, J. C., Wolf, S., Tejwani, R., Jiang, R., Pomann, G.-M., Goldstein, B. A., … Allori, A. C. (2019). Early Impact of the Patient Protection and Affordable Care Act on Delivery of Children's Surgical Care. Clin Pediatr (Phila), 58(4), 453–460. https://doi.org/10.1177/0009922818825156
Routh, Jonathan C., Steven Wolf, Rohit Tejwani, Ruiyang Jiang, Gina-Maria Pomann, Benjamin A. Goldstein, Matthew L. Maciejewski, and Alexander C. Allori. “Early Impact of the Patient Protection and Affordable Care Act on Delivery of Children's Surgical Care.Clin Pediatr (Phila) 58, no. 4 (April 2019): 453–60. https://doi.org/10.1177/0009922818825156.
Routh JC, Wolf S, Tejwani R, Jiang R, Pomann G-M, Goldstein BA, et al. Early Impact of the Patient Protection and Affordable Care Act on Delivery of Children's Surgical Care. Clin Pediatr (Phila). 2019 Apr;58(4):453–60.
Routh, Jonathan C., et al. “Early Impact of the Patient Protection and Affordable Care Act on Delivery of Children's Surgical Care.Clin Pediatr (Phila), vol. 58, no. 4, Apr. 2019, pp. 453–60. Pubmed, doi:10.1177/0009922818825156.
Routh JC, Wolf S, Tejwani R, Jiang R, Pomann G-M, Goldstein BA, Maciejewski ML, Allori AC. Early Impact of the Patient Protection and Affordable Care Act on Delivery of Children's Surgical Care. Clin Pediatr (Phila). 2019 Apr;58(4):453–460.
Journal cover image

Published In

Clin Pediatr (Phila)

DOI

EISSN

1938-2707

Publication Date

April 2019

Volume

58

Issue

4

Start / End Page

453 / 460

Location

United States

Related Subject Headings

  • Young Adult
  • United States
  • Surgical Procedures, Operative
  • Pediatrics
  • Patient Protection and Affordable Care Act
  • Medicaid
  • Male
  • Infant, Newborn
  • Infant
  • Humans