TY - JOUR
T1 - Has the Expansion of Health Insurance Coverage via the Implementation of the Affordable Care Act Influenced Inequities in Coronary Revascularization in New York City?
AU - Weisz, Daniel
AU - Gusmano, Michael K.
AU - Amba, Vineeth
AU - Rodwin, Victor G.
N1 - Publisher Copyright:
© 2023, W. Montague Cobb-NMA Health Institute.
PY - 2023
Y1 - 2023
N2 - Background/Purpose: In 2014, New York City implemented the Affordable Care Act (ACA) leading to insurance coverage gains intended to reduce inequities in healthcare services use. The paper documents inequalities in coronary revascularization procedures (percutaneous coronary intervention and coronary artery bypass grafting) usage by race/ethnicity, gender, insurance type, and income before and after the implementation of the ACA. Methods: We used data from the Healthcare Cost and Utilization Project to identify NYC patients hospitalized with the diagnosis of coronary artery disease (CAD) and/or congestive heart failure (CHF) in 2011–2013 (pre-ACA) and 2014–2017 (post-ACA). Next, we calculated age-adjusted rates of CAD and/or CHF hospitalization and coronary revascularization. Logistic regression models were used to identify the variables associated with receiving a coronary revascularization in each period. Results: Age-adjusted rates of CAD and/or CHF hospitalization and coronary revascularization in patients 45–64 years of age and 65 years of age and older declined in the post-ACA period. Disparities by gender, race/ethnicity, insurance type, and income in the use of coronary revascularization persist in the post-ACA period. Conclusions: Although this health care reform law led to the narrowing of inequities in the use of coronary revascularization, disparities persist in NYC in the post-ACA period.
AB - Background/Purpose: In 2014, New York City implemented the Affordable Care Act (ACA) leading to insurance coverage gains intended to reduce inequities in healthcare services use. The paper documents inequalities in coronary revascularization procedures (percutaneous coronary intervention and coronary artery bypass grafting) usage by race/ethnicity, gender, insurance type, and income before and after the implementation of the ACA. Methods: We used data from the Healthcare Cost and Utilization Project to identify NYC patients hospitalized with the diagnosis of coronary artery disease (CAD) and/or congestive heart failure (CHF) in 2011–2013 (pre-ACA) and 2014–2017 (post-ACA). Next, we calculated age-adjusted rates of CAD and/or CHF hospitalization and coronary revascularization. Logistic regression models were used to identify the variables associated with receiving a coronary revascularization in each period. Results: Age-adjusted rates of CAD and/or CHF hospitalization and coronary revascularization in patients 45–64 years of age and 65 years of age and older declined in the post-ACA period. Disparities by gender, race/ethnicity, insurance type, and income in the use of coronary revascularization persist in the post-ACA period. Conclusions: Although this health care reform law led to the narrowing of inequities in the use of coronary revascularization, disparities persist in NYC in the post-ACA period.
KW - 00A06 Mathematics for nonmathematicians
KW - Affordable Care Act
KW - Coronary revascularization inequities
KW - Insurance
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U2 - 10.1007/s40615-023-01650-1
DO - 10.1007/s40615-023-01650-1
M3 - Article
AN - SCOPUS:85162229475
SN - 2197-3792
JO - Journal of Racial and Ethnic Health Disparities
JF - Journal of Racial and Ethnic Health Disparities
ER -