The impact of Medicaid expansion on asthma-related health care services utilization and expenditure

The purpose of this study was to examine the effect of Medicaid expansion on asthma-related health care services utilization and expenditures among low-income adult patients with asthma aged 26-64. Using a pooled dataset from 2007 to 2018 Medical Expenditures Panel Surveys (MEPS), we implemented a m...

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Bibliographic Details
Published in:The Journal of asthma Vol. 60; no. 1; pp. 43 - 56
Main Authors: Shi, Lu, Yoon, Jangho, Li, Tao, Jeff, Luck
Format: Journal Article
Language:English
Published: England Taylor & Francis 02.01.2023
Subjects:
Adult
Asthma - therapy
difference-in-differences
Facilities and Services Utilization
Health care utilization and expenditures
Health Expenditures
Health Services Accessibility
Humans
Medicaid
medicaid expansion
prescription drugs
United States
United States
Health care utilization and expenditures
difference-in-differences
medicaid expansion
prescription drugs
ISSN:0277-0903, 1532-4303, 1532-4303
Online Access:Get full text
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Summary:The purpose of this study was to examine the effect of Medicaid expansion on asthma-related health care services utilization and expenditures among low-income adult patients with asthma aged 26-64. Using a pooled dataset from 2007 to 2018 Medical Expenditures Panel Surveys (MEPS), we implemented a multivariate difference-in-differences analysis, which compared changes in utilization and expenditures for asthma-related health care services among adult patients with asthma with income below 133% Federal Poverty Level (FPL) vs. above 133%-400% FPL, before and after Medicaid expansion in 2014. We used negative binomial models to analyze utilization outcomes. Expenditures were estimated using two-part models with logit as the first part and generalized linear models as the second part. Estimates were weighted for the complex multi-stage sampling design of MEPS. Medicaid expansion was associated with increases in both utilization and expenditures for asthma-related prescription drugs among low-income patients with asthma, by 1.8 prescription fills (p < 0.05) and $233 (p < 0.05) per year, respectively. No statistically significant association was detected for other asthma-related health care services. Medicaid expansion led to an increase in accessibility of prescription drugs among low-income asthma patients, but had no effect on other asthma-related health care services.
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ISSN:0277-0903
1532-4303
1532-4303
DOI:10.1080/02770903.2021.2025389