Evidence map›Paper›PMID 30947608›Full record

SynthesisInquiry : a journal of medical care organization, provision and financing

Medicaid Patients Have Greater Difficulty Scheduling Health Care Appointments Compared With Private Insurance Patients: A Meta-Analysis.

Walter R Hsiang, Adam Lukasiewicz, Mark Gentry, Chang-Yeon Kim, Michael P Leslie, Richard Pelker, Howard P Forman, Daniel H Wiznia

Abstract readMeta-AnalysisSystematic Review
In one paragraph

Synthesis in Inquiry : a journal of medical care organization, provision and financing. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 110 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
110citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

110 citing papers in PubMed, 2 syntheses or guidelines pooled it.

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50 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Walter R Hsiang1 Yale School of Medicine, New Haven, CT, USA.ORCID 0000-0002-4718-6231
Adam Lukasiewicz1 Yale School of Medicine, New Haven, CT, USA.
Mark Gentry1 Yale School of Medicine, New Haven, CT, USA.ORCID 0000-0002-3542-8803
Chang-Yeon Kim2 University Hospitals Cleveland Medical Center, OH, USA.
Michael P Leslie1 Yale School of Medicine, New Haven, CT, USA.
Richard Pelker1 Yale School of Medicine, New Haven, CT, USA.
Howard P Forman1 Yale School of Medicine, New Haven, CT, USA.
Daniel H Wiznia1 Yale School of Medicine, New Haven, CT, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Medicaid patients are known to have reduced access to care compared with privately insured patients; however, quantifying this disparity with large controlled studies remains a challenge. This meta-analysis evaluates the disparity in health services accessibility of appointments between Medicaid and privately insured patients through audit studies of health care appointments and schedules. Audit studies evaluating different types of outpatient physician practices were selected. Studies were categorized based on the characteristics of the simulated patient scenario. The relative risk of appointment availability was calculated for all different types of audit scenario characteristics. As a secondary analysis, appointment availability was compared pre- versus post-Medicaid expansion. Overall, 34 audit studies were identified, which demonstrated that Medicaid insurance is associated with a 1.6-fold lower likelihood in successfully scheduling a primary care appointment and a 3.3-fold lower likelihood in successfully scheduling a specialty appointment when compared with private insurance. In this first meta-analysis comparing appointment availability between Medicaid and privately insured patients, we demonstrate Medicaid patients have greater difficulty obtaining appointments compared with privately insured patients across a variety of medical scenarios.

Indexed as

Appointments and SchedulesHealthcare DisparitiesHealth Services AccessibilityInsurance CoverageInsurance, HealthHumansMedicaidPatient Protection and Affordable Care ActPrimary Health CareUnited Statesappointments and scheduleshealthcare disparitieshealth services accessibilityinsuranceMedicaidmeta-analysispatient protection and affordable care actprimary health care

Identifiers

PMID30947608
PMCPMC6452575

What Socratic holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.