The use of major inpatient procedures among nonelderly lower and medium area income populations, Hispanics and whites increased following the 2006 launch of Massachusetts' healthcare reform, suggesting improved access to outpatient care, according to a study in Medical Care.
Researchers studied Massachusetts hospitalizations for 21 months before and after health reform implementation — from July 1, 2006 to Dec. 31, 2007. They assessed the utilization of 17 nonobstetrical major therapeutic procedures, including surgical procedures, for which more than 70 percent of hospitalizations were initiated by outpatient physician referral. The patient population studied included adults aged 40 or older, defined as nonelderly.
They found an overall increase in procedure rates post-reform among all populations studied. These are the increases from pre-reform to post-reform after adjusting for secular changes unrelated to reform:
• Nonelderly low area income — 13 percent.
• Nonelderly medium area income — 15 percent.
• Nonelderly Hispanic — 22 percent.
• Nonelderly black — 5 percent.
• Nonelderly white — 7 percent.
The researchers suggested the increased use of major inpatient procedures in these populations could reflect improved access to outpatient care, as patients receive inpatient services often by the referral of outpatient physicians.
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Researchers studied Massachusetts hospitalizations for 21 months before and after health reform implementation — from July 1, 2006 to Dec. 31, 2007. They assessed the utilization of 17 nonobstetrical major therapeutic procedures, including surgical procedures, for which more than 70 percent of hospitalizations were initiated by outpatient physician referral. The patient population studied included adults aged 40 or older, defined as nonelderly.
They found an overall increase in procedure rates post-reform among all populations studied. These are the increases from pre-reform to post-reform after adjusting for secular changes unrelated to reform:
• Nonelderly low area income — 13 percent.
• Nonelderly medium area income — 15 percent.
• Nonelderly Hispanic — 22 percent.
• Nonelderly black — 5 percent.
• Nonelderly white — 7 percent.
The researchers suggested the increased use of major inpatient procedures in these populations could reflect improved access to outpatient care, as patients receive inpatient services often by the referral of outpatient physicians.
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