Evaluating the early impact of Medicaid expansion on trends in diagnosis and treatment of benign gallbladder disease in Kentucky.
BACKGROUND
In January 2014, Kentucky expanded Medicaid coverage in an effort to improve access to healthcare. This study evaluated the early impact of Medicaid expansion on diagnosis and treatment of benign gallbladder disease in Kentucky.


METHODS
Administrative claims data were queried for patients undergoing cholecystectomy for benign gallbladder disease between 2011 and 2015. Demographic, procedure, and outcome variables from 2011 to 2013 (PRE) and 2014-2015 (POST) were compared.


RESULTS
After Medicaid expansion, patients were more likely to have their operation performed as an outpatient (80.0% vs. 78.2%, p < 0.001). A significant trend was noted toward a shorter hospital stay (p < 0.001) among inpatients. For both inpatients and outpatients, a significant shift was noted toward increased hospital charges (p < 0.001).


CONCLUSIONS
The expansion of Kentucky Medicaid in 2014 has been associated with an increase in outpatient cholecystectomy, shorter hospital stays for inpatients, and increased hospital charges for both inpatients and outpatients. Increased charges for all procedures may represent a mechanism for hospitals to offset the cost of providing global care for more patients.
['Bhutiani|N|N|', 'Harbrecht|B G|BG|', 'Scoggins|C R|CR|', 'Bozeman|M C|MC|']
D000293:Adolescent D000328:Adult D002763:Cholecystectomy D003695:Delivery of Health Care D005705:Gallbladder Diseases D006801:Humans D007629:Kentucky D008484:Medicaid D008875:Middle Aged D012189:Retrospective Studies D013997:Time Factors D014481:United States D055815:Young Adult
Medicaid Cholecystectomy Health policy