Table 1. Baseline Characteristics and Outcomes for Hospitalizations of Adults With Diabetic Foot Ulcerations in Early-Adopter and Nonadopter States Before and After Medicaid Expansion.
| Characteristics | Hospitalizations, No. (%) | |||
|---|---|---|---|---|
| Early-adopter states | Nonadopter states | |||
| Pre-ACA (n = 52 854) | Post-ACA (n = 100 078) | Pre-ACA (n = 38 880) | Post-ACA (n = 76 239) | |
| Age, y | ||||
| 20-34 | 2031 (3.8) | 4103 (4.1) | 1863 (4.8) | 3642 (4.8) |
| 35-49 | 13 447 (25.4) | 24 937 (24.9) | 10 452 (26.9) | 20 243 (26.6) |
| 50-64 | 37 376 (70.7) | 71 038 (71.0) | 26 565 (68.3) | 52 354 (68.7) |
| Gender | ||||
| Male | 35 693 (67.5) | 68 500 (68.4) | 25 165 (64.7) | 49 464 (64.9) |
| Female | 17 161 (32.5) | 31 578 (31.6) | 13 715 (31.6) | 26 775 (35.1) |
| Race/ethnicity | ||||
| African American | 11 029 (20.9) | 20 082 (20.1) | 13 125 (33.8) | 25 412 (33.3) |
| Hispanic | 7048 (13.3) | 12 652 (12.6) | 3249 (8.4) | 6315 (8.3) |
| White | 30 580 (57.9) | 58 878 (58.8) | 21 360 (54.9) | 42 162 (55.3) |
| Othera | 4197 (7.9) | 8466 (8.5) | 1146 (2.9) | 2350 (3.1) |
| Health insurance | ||||
| Medicaid | 13 222 (25.0) | 31 812 (31.8) | 8422 (21.7) | 15 935 (20.9) |
| Medicare | 18 772 (35.5) | 35 447 (35.4) | 15 222 (39.2) | 29 778 (39.1) |
| Other | 1740 (3.3) | 2102 (2.1) | 1689 (4.3) | 3170 (4.2) |
| Private | 14 687 (27.8) | 27 272 (27.3) | 8456 (21.7) | 18 264 (24.0) |
| Uninsured | 4433 (8.4) | 3445 (3.4) | 5091 (13.1) | 9092 (11.9) |
| Area of residency | ||||
| Not urban | 2803 (5.3) | 4935 (4.9) | 3399 (8.7) | 6636 (8.7) |
| Urban | 50 051 (94.7) | 95 143 (95.1) | 35 481 (91.3) | 69 603 (91.3) |
| Medical comorbidities | ||||
| Hypertension | 36 316 (68.7) | 68 375 (68.3) | 28 037 (72.1) | 54 540 (71.5) |
| Peripheral artery disease | 12 879 (24.4) | 23 680 (23.7) | 9116 (23.4) | 17 651 (23.2) |
| Congestive heart failure | 6817 (12.9) | 13 766 (13.8) | 5037 (13.0) | 10 457 (13.7) |
| Chronic lung disease | 7613 (14.4) | 14 271 (14.3) | 5047 (13.0) | 10 054 (13.2) |
| Kidney failure | 16 446 (31.1) | 30 951 (30.9) | 12 490 (32.1) | 24 551 (32.2) |
| Outcomes | ||||
| Major amputation | 3445 (6.5) | 6490 (6.5) | 3125 (8.0) | 6097 (8.0) |
| Length of stay, mean (SD), d | 7.92 (9.35) | 7.92 (9.05) | 8.11 (8.64) | 8.03 (8.68) |
Abbreviation: ACA, the Patient Protection and Affordable Care Act.
a
Other includes Asian or Pacific Islander, American Indian or Alaska Native, and Other.