TennCare disenrollment and avoidable hospital visits in Davidson County, Tennessee.
The objective of this study was to determine if an association existed between the mid-2005 TennCare (Medicaid) disenrollment and increases in uninsured ambulatory care sensitive condition (ACSC) non-admitted ER visits and inpatient hospitalizations in Davidson County, Tennessee (= the city of Nashville). Logistic regression modeling, using an interactive term for insurance category x year, indicated that the effect of no insurance on ACSC ER visits increased by 18% from 2003 to 2007 (p&lt;.001), but no significant effect was found for uninsured ACSC inpatient hospitalizations. These greater odds of ACSC ER visits among uninsured patients were associated with a 60% increase in hospitals' bad debt write offs during this same time period. Therefore, the TennCare disenrollment was associated with increased likelihood of uninsured ACSC non-admitted ER visits and greater financial losses for Davidson County hospitals during this time period.
Center for Prevention Research, Tennessee State University,Nashville, TN 37209, USA. jemerson@tnstate.edu
Janice S
JS
Emerson
Pamela C
PC
Hull
Van A
VA
Cain
Meggan
M
Novotny
Rodney E
RE
Stanley
Robert S
RS
Levine
D000293:Adolescent; D000328:Adult; D000553:Ambulatory Care / Q000191:economics / Q000706:statistics & numerical data*; D004608:Eligibility Determination; D004636:Emergency Service, Hospital / Q000191:economics / Q000706:statistics & numerical data*; D005260:Female; D006760:Hospitalization / Q000191:economics / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008484:Medicaid / Q000458:organization & administration*; D017057:Medically Uninsured; D008875:Middle Aged; D013714:Tennessee; D017664:Uncompensated Care / Q000191:economics / Q000706:statistics & numerical data*; D014481:United States; D055815:Young Adult