MedicalResearch.com Interview with:
Amal Trivedi, MD, MPH
Associate Professor of Health Services, Policy and Practice
Associate Professor of Medicine
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: The Affordable Care Act Medicaid expansion gave states the option to expand coverage to low-income adults. Prior research has reported that these expansions have been associated with increased coverage, improved access to care, and in some studies better self-rated health. To date the impact of Medicaid expansion on mortality rates, particularly for persons with serious chronic illness, remains unknown.
Our study found an association between Medicaid expansion and lower death rates for patients with end-stage renal disease in the first year after initiating dialysis. Specifically, we found an absolute reduction in 1-year mortality in expansion states of -0.6 percentage points, which represents a 9% relative reduction in 1-year mortality.
MedicalResearch.com: What should readers take away from your report?
Response: Our study suggests that coverage expansion may have important health consequences for persons with end-stage renal disease.
MedicalResearch.com: What recommendations do you have for future research as a result of this work?
Response: Future research is needed to understand the causal effects of insurance coverage among patients with end-stage renal disease.
Swaminathan S, Sommers BD, Thorsness R, Mehrotra R, Lee Y, Trivedi AN. Association of Medicaid Expansion With 1-Year Mortality Among Patients With End-Stage Renal Disease. JAMA. Published online October 25, 2018. doi:10.1001/jama.2018.16504
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