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Impact of the Affordable Care Act on Trauma and Emergency General Surgery2017

Type: New Evidence Based Review (EBR)
Category: Emergency General Surgery
Committee Liaison: Bryce R.H. Robinson, MD, MS, FACS, FCCM


Team leader(s)

The Eastern Association for the Surgery of Trauma is creating an Evidence Based Review (EBR) using the GRADE methodology of the impact of the Affordable Care Act on trauma and emergency general surgery. The Affordable Care Act was enacted in 2010. Since it has been law, many studies have looked at the effect it has had on trauma and emergency general surgery systems, providers, and patients.

Working Group Members
Anthony Bottiggi, MD
Marie Crandall, MD, MPH
Edward E. Cornwell, III, MD
Alexander Eastman, MD, MPH
Steven C. Gale, MD
Elliott R. Haut, MD, PhD
Bellal Joseph, MD
Jennifer C. Knight, MD
Bryce R.H. Robinson, MD, MS
Andrew Schoenfeld, MD
Jonathan Scott, MD, MPH
Shahid Shafi, MD, MPH
Nicole A. Stassen, MD
Cassandra White, MD
Brian Williams, MD
Mallory Williams, MD, MPH
Yasmin A. Zerhouni, MD

PICO 1- What is the impact of Medicaid Expansion compared to no Medicaid Expansion for trauma patients? 

P- trauma patients

I- Medicaid expansion/Massachusetts Health Care Reform

C- No Medicaid expansion

O-

  • death/disposition
  • costs
  • insurance (all outcomes related to insurance status)
  • access/timeliness of care
  • complications*

 

PICO 2- What is the impact of Medicaid Expansion compared to no Medicaid Expansion for emergency general surgery patients? 

P- emergency general surgery patients

I- Medicaid expansion/Massachusetts Health Care Reform

C- No Medicaid expansion

O-

  • death/disposition
  • costs
  • insurance (all outcomes related to insurance status)
  • access/timeliness of care
  • complications*

 

PICO 3- What is the impact of Medicaid Expansion compared to no Medicaid Expansion for trauma systems? 

P- trauma systems

I- Medicaid expansion/Massachusetts Health Care Reform

C- No Medicaid expansion

O-

  • access to care
  • reimbursement to and avoiding closure of trauma systems
  • costs
  • expansion/state funding of trauma systems
  • disparities in care
  • distance to trauma center
  • outcomes by trauma centers


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Eastern Association for the Surgery of Trauma

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