Medicaid Status and Treatment Disparities in Children with Asthma


Researchers examine whether insurance status impacts treatment of children with asthma.

Medicaid-insured children receive the same asthma treatment as children with other insurance, a recent study found.

In the study, published by Pediatrics, researchers examined hospital practice patterns to compare costs, length of stay, and use of the intensive care unit (ICU).

"Because Medicaid payments to providers may be considerably lower than reimbursements from private medical insurance, we asked whether the care of Medicaid patients differed from the care of non-Medicaid patients within the same hospital," said study author Jeffrey H. Silber, MD, PhD "From a policy perspective, the answer is reassuring--Medicaid and non-Medicaid patients received comparable treatment."

Included in the study were 17,000 pairs of pediatric patients admitted for acute asthma from 2011 to 2014 matched for age, sex, and severity of the condition. Researchers said that matching similar patients allows for a more accurate comparison of patient resources, according to the study.

They found that the median cost for Medicaid patients was $4263 and $4160 for non-Medicaid patients. Both groups had an average hospital stay of 1 day.

ICU use was very similar for both, used by approximately 7.1% of Medicaid patients and 6.7% of non-Medicaid patients.

Only 2 hospitals showed significant differences in the groups. Higher costs for Medicaid patients were found in 1 hospital and higher costs for non-Medicaid patients were found in the other hospital, according to the study.

"Ongoing monitoring for disparities in treatment is a fundamental responsibility of any insurance system, but must be done with great care," Dr Silber concluded. "We have demonstrated that multivariate matching is ideally suited to ensure fairness when comparing groups of children, allowing for more meaningful audits, and for potentially actionable results should differential care be observed. For asthma, we are glad to report that we did not find meaningful differences in treatment style between Medicaid and non-Medicaid children hospitalized for asthma inside children's hospitals."

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