Researchers at Baylor University College of Medicine Target Managed Care (Specialist Access and Leg Amputations Among Texas Medicaid Patients): Managed Care

Health Policy and Law Daily

2023 MAY 02 (NewsRx) -- By a News Reporter-Staff News Editor at Health Policy and Law Daily -- Investigators publish new report on Managed Care. According to news reporting originating in Houston, Texas, by NewsRx journalists, research stated, “Medicaid coverage among patients with peripheral artery disease (PAD) has been associ-ated with higher rates of primary amputations. We sought to determine the relative con-tributions of clinical, demographic, and hospital factors to leg amputations among Texas Medicaid patients.”

The news reporters obtained a quote from the research from the Baylor University College of Medicine, “level data were used to identify patients who underwent treat-ment for PAD-related foot complications in Texas. Patients were categorized into groups by insurance provider (Medicaid, Medicare, dual-enrollee, commercial, and provider network). Individual-and area-level multivariate analyses were used to find associations with pri-mary amputation. Of 21,592 patients identified, 8.8% were covered by Medicaid, 35.3% by Medicare, 27.8% by Medicare and Medicaid, 7.3% by commercial insurance, and 20.7% by a provider network. Compared with commercially insured patients, Medicaid patients more often underwent amputation (33% v 49%), were categorized as Black or Hispanic (45% v 64%), presented with gangrene (61% v 71%), were admitted through an emergency department (61% v 73%), and were admitted to a safety net hospital (3% v 16%). They had lower relative rates of outpatient evaluation (1.33 v 0.55) and their hospitalizations were less centralized (Gini coefficient 0.43 v 0.39) ( P< .001 for all). Amputations among Medicaid patients were associated with infection and gangrene, care at safety net hospitals, rate of outpatient visits, and Black and Hispanic race, even after risk-adjustment ( P< .001). Leg amputations among Medicaid patients were associated with race, disease severity, hospital characteristics, and outpatient evaluation rates, but not with provider density and location.”

According to the news reporters, the research concluded: “Focusing efforts on preventative care and early outpatient referrals could help address this disparity.(.”

This research has been peer-reviewed.

For more information on this research see: Specialist Access and Leg Amputations Among Texas Medicaid Patients. Seminars in Vascular Surgery, 2023;36(1):49-57. Seminars in Vascular Surgery can be contacted at: W B Saunders Co-elsevier Inc, 1600 John F Kennedy Boulevard, Ste 1800, Philadelphia, PA 19103-2899, USA. (Elsevier - www.elsevier.com; Seminars in Vascular Surgery - http://www.journals.elsevier.com/seminars-in-vascular-surgery/)

Our news correspondents report that additional information may be obtained by contacting Deeksha Bidare, Baylor University College of Medicine, Dept. of Student Affairs, One Baylor Plaza, Houston, TX 77030, United States. Additional authors for this research include Sherene Sharath, Neal R. Barshes and Fred Cerise.

The direct object identifier (DOI) for that additional information is: https://doi.org/10.1053/j.semvascsurg.2022.12.003. This DOI is a link to an online electronic document that is either free or for purchase, and can be your direct source for a journal article and its citation.