Senior author Nancy Kressin, professor of medicine at Boston University Schools of Medicine, and colleagues at the VA Boston Healthcare System and Harvard Medical School analyzed discharge data on Massachusetts hospitalizations for 21 months preceding and following health reform implementation.
They identified all non-obstetrical major therapeutic procedures for patients age 40 and older, and compared pre- and post-reform utilization of major therapeutic inpatient surgical procedures predominantly scheduled by outpatient referrals among non-elderly Massachusetts adults, Kressin said.
The study found inpatient medical procedures increased more among non-elderly, lower- and medium- income populations, Hispanics and whites, after healthcare reform went into effect in Massachusetts.
"Prior to reform, both blacks and Hispanics had lower rates of these procedures compared to whites," Kressin said in a statement. "As 90 percent of all surgeries came from outpatient physician referral, these findings suggest a meaningful improvement in access to outpatient care for the surgeries studied, especially those living in lower income areas."
The findings, published in Medical Care, suggested potentially improved access to outpatient care and might reflect demand built up prior to reform when individuals were uninsured.