Study Data from Yale University School of Public Health Provide New Insights into Managed Care (Association Between Medicare Eligibility At Age 65 Years and In-hospital Treatment Patterns and Health Outcomes for Patients With Trauma: Regression …): Managed Care

Health Policy and Law Daily

2023 SEP 08 (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 out of New Haven, Connecticut, by NewsRx editors, research stated, “To determine whether health systems in the United States modify treatment or discharge decisions for otherwise similar patients based on health insurance coverage. Regression discontinuity approach. American College of Surgeons’ National Trauma Data Bank, 2007-17.”

Our news journalists obtained a quote from the research from the Yale University School of Public Health, “Adults aged between 50 and 79 years with a total of 1 586 577 trauma encounters at level I and level II trauma centers in the US. Eligibility for Medicare at age 65 years. The main outcome measure was change in health insurance coverage, complications, in-hospital mortality, processes of care in the trauma bay, treatment patterns during hospital admission, and discharge locations at age 65 years. 1 586 577 trauma encounters were included. At age 65, a discontinuous increase of 9.6 percentage points (95% confidence interval 9.1 to 10.1) was observed in the share of patients with health insurance coverage through Medicare at age 65 years. Entry to Medicare at age 65 was also associated with a decrease in length of hospital stay for each encounter, of 0.33 days (95% confidence interval-0.42 to-0.24 days), or nearly 5%), which coincided with an increase in discharges to nursing homes (1.56 percentage points, 95% confidence interval 0.94 to 2.16 percentage points) and transfers to other inpatient facilities (0.57 percentage points, 0.33 to 0.80 percentage points), and a large decrease in discharges to home (1.99 percentage points,-2.73 to-1.27 percentage points). Relatively small (or no) changes were observed in treatment patterns during the patients’ hospital admission, including no changes in potentially life saving treatments (eg, blood transfusions) or mortality.”

According to the news editors, the research concluded: “The findings suggest that differences in treatment for otherwise similar patients with trauma with different forms of insurance coverage arose during discharge planning process, with little evidence that health systems modified treatment decisions based on patients’ coverage.”

This research has been peer-reviewed.

For more information on this research see: Association Between Medicare Eligibility At Age 65 Years and In-hospital Treatment Patterns and Health Outcomes for Patients With Trauma: Regression Discontinuity Approach. BMJ, 2023;382. BMJ can be contacted at: Bmj Publishing Group, British Med Assoc House, Tavistock Square, London WC1H 9JR, England.

Our news journalists report that additional information may be obtained by contacting Deepon Bhaumik, Yale University School of Public Health, Dept. of Health Policy and Management, New Haven, CT 06510, United States. Additional authors for this research include Chima D. Ndumele, Jacob Wallace and John W. Scott.

The direct object identifier (DOI) for that additional information is: https://doi.org/10.1136/bmj-2022-074289. 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.