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Neurologic disorders in Medicaid vs privately insured children and working-age adults
Farrah J Mateen1, Joseph P Geer1, Kevin Frick1
1Department of Neurology (FJM), Massachusetts General Hospital, Boston; Departments of International Health (FJM) and Health Policy and Management (KF), The Bloomberg School of Public Health, The Johns Hopkins University, Baltimore; Department of Neurology (JPG), Johns Hopkins Hospital, Baltimore, MD; and Department of Biostatistics (MC), School of Public Health, University of Washington, Seattle, WA.
Abstract:
This retrospective, observational study reports health utilization and access patterns of Medicaid recipients for neurologic diseases compared to privately insured individuals seen in 2 hospitals at a single institution in the same time period. We reviewed records of patients and compared demographic characteristics, visit types, neurologic diagnoses, and all-cause mortality, by age group, when seen with Medicaid vs private insurance. Adults insured by Medicaid were more likely to present as inpatients and with life-threatening neurologic disease compared to privately insured patients. Moreover, adult patients presenting with neurologic disease on Medicaid had a higher all-cause mortality rate than privately insured patients. Similar disparities in neurologic disease were not observed in children. The relationship of these findings to patient educational status, household income, comorbidities, and the reasons prompting Medicaid eligibility require additional study.
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