Quality of Hospital Care of Children With Asthma: Medicaid Versus Privately Insured Patients

Abstract

Asthma is an important condition to study in the Medicaid population because it is the most frequent reason for hospital admission of Medicaid children, with rates substantially higher than those of non-Medicaid children. This study addressed how the quality of hospital care provided to children with asthma on Medicaid compares with that provided to privately insured children. Children inpatient records were studied in California, Georgia, and Michigan, comparing the care that was provided to standards created by a national panel of physician experts. Process-of-care analysis showed that Medicaid children in each state were more likely than privately insured children to be discharged on suboptimal medication regimens. This study concluded that hospitals serving Medicaid children, at least in these three states, are providing asthma inpatient care of fairly comparable quality to that of privately insured children. However, there remain significant problems surrounding outpatient medication regimens and follow-up care.

Predictors of Warfarin Use Among Ohio Medicaid Patients With New-Onset Nonvalvular Atrial Fibrillation

“…The high prevalence in the Medicaid population of conditions such as mental illness, substance abuse, homelessness, inadequate housing, absence of a caregiver, and noncompliance is not surprising, and these factors have been associated with adverse health outcomes in other clinical settings. [22][23][24][25][26][27] Other findings of our study are consistent with those of other studies that have examined the use of warfarin in patients with AF. The most consistent and perhaps the most concerning finding is that older age predicts nonprescription of warfarin.…”

Quality of Care for Children Hospitalized With Asthma

“…Despite the fact that asthma is associated with significant inpatient burden, previous studies of asthma quality of care focused on outpatient and ED settings. [10][11][12][13] In contrast, our study focused solely on inpatient care and attempted to describe the quality of asthma care in this setting. Our study was conducted between 2005 and 2006 and preceded the publication of Joint Commission inpatient asthma measures.…”

Quality of Care for Women Undergoing a Hysterectomy: Effects of Insurance and Race/Ethnicity

“…We report the results of our hysterectomy analysis; a study of quality of care provided to children hospitalized with asthma, which used the same methods, has been published elsewhere. 7 We chose to analyze hysterectomy for 2 reasons: (1) it is one of the most costly procedures for nonpregnant women younger than 65 years and in the Medicaid program, and (2) it is a highvolume procedure and therefore of particular interest. 8 Our choice was further influenced by a concern about the appropriateness of hysterectomy versus uterus-preserving treatments among low-income women.…”