TUESDAY, Nov. 17, 2020 — Insurance expansion under the Affordable Care Act (ACA) was associated with a reduction in the emergency medical services (EMS) dispatch rate for asthma-related emergencies, according to a study published online Nov. 11 in JAMA Network Open.
Gregory A. Peters, M.D., from the Massachusetts General Hospital in Boston, and colleagues examined the association between health insurance expansion and EMS dispatches for asthma in a cohort study examining 14,865,267 ambulance calls dispatched within New York City from 2008 to 2018, including 217,303 calls for asthma-related emergencies.
The researchers found that after ACA implementation, there was a decrease in the asthma EMS dispatch rate, from a mean of 261 dispatches per 100,000 population per year preintervention to 211 postintervention. In an interrupted time series analysis, this decrease was significant. The annual asthma EMS dispatch rate was increasing by 11.8 calls per 100,000 population per year prior to 2014; while the asthma EMS dispatch rate decreased annually by 28.5 calls per 100,000 population per year after ACA implementation, representing a significant change in slope from the preintervention period. A 1 percent decrease in the citywide uninsured rate was associated with a decrease of 98.9 asthma dispatches per 100,000 population per year in a multivariable linear regression analysis.
“Our analysis of the effects of a major health policy change like the Affordable Care Act on a high-volume EMS system like the one in New York City provides valuable insights for public health officials,” Peters said in a statement.
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