Table 3.
Changes in rates of preventable hospital admissions per 100 000 residents/year in Massachusetts and control states (NY, NJ, PA) before (1 October 2004-30 June 2006) and after (1 January 2008-30 September 2009) healthcare reform according to race and ethnicity
| ASCS measures | Massachusetts | Control states | Differences in differences estimates | Adjusted estimated % change (95% CI)† | |||||||
|---|---|---|---|---|---|---|---|---|---|---|---|
| Before | After | % change | Before | After | % change | Unadjusted | Adjusted (95% CI)* | ||||
| Overall composite | |||||||||||
| White | 667 | 647 | −3.0 | 716 | 680 | −5.1 | 2.1 | 2.1 (−0.8 to 5.0) | Ref | ||
| Black | 1713 | 1744 | 1.8 | 2188 | 2240 | 2.4 | −0.6 | −0.5 (−6.0 to 5.3) | −1.9 (−8.5 to 5.1) | ||
| Hispanic | 1258 | 1203 | −4.4 | 1126 | 1024 | −9.1 | 4.7 | 1.6 (−3.9 to 5.5) | 2.0 (−7.5 to 12.4) | ||
| Acute composite | |||||||||||
| White | 285 | 263 | −7.5 | 277 | 262 | −5.6 | −1.9 | −1.8 (−5.2 to 1.7) | Ref | ||
| Black | 496 | 470 | −5.3 | 482 | 476 | −1.2 | −4.0 | −4.0 (−12.2 to 5.1) | −1.4 (−12.7 to 11.4) | ||
| Hispanic | 393 | 362 | −7.8 | 297 | 276 | −7.3 | −0.5 | −1.2 (−9.9 to 8.3) | 2.0 (−10.3 to 15.7) | ||
| Chronic composite | |||||||||||
| White | 383 | 384 | 0.3 | 440 | 419 | −4.7 | 5.0 | 5.0 (1.6 to 8.6) | Ref | ||
| Black | 1217 | 1274 | 4.7 | 1706 | 1764 | 3.4 | 1.3 | 1.3 (−4.9 to 7.9) | −3.1 (−9.4 to 3.7) | ||
| Hispanic | 865 | 840 | −2.8 | 829 | 748 | −9.7 | 6.9 | 2.9 (−3.4 to 9.5) | −0.7 (−9.6 to 12.2) | ||
*Adjusted difference in differences estimates and 95% CI obtained from Poisson regression models adjusted for sex, age, race/ethnicity, county income level, county unemployment rate, quarter, and Health Professions Shortage Area designation.
†For change in racial/ethnic disparities in MA v controls. Expresses change in disparities after reform between black and white people and between Hispanic and white people in ACSC (preventable hospitalization) rates after adjustment for changes in control states.