Thursday, April 28, 2022 | The Latest Research, Commentary, And News From Health Affairs
Dear John,
An April article examines the association between Medicaid expansion and closure of hospital-based obstetric services.
Hospital-Based Obstetric Services
Medicaid expansion has reduced hospital closures overall.
However, according to Caitlin Carroll and coauthors in their April Health Affairs article, there is no relationship between Medicaid expansion and retention of obstetric units or survival of hospitals offering obstetric services.
"Access to obstetric services has declined steadily during the past decade, driven by the closure of hospital-based obstetric units and of entire hospitals," Carroll and coauthors explain.
Using national hospital data from the period 2010–18, they found that while expansion led to a reduction in hospital closures, that reduction was concentrated among hospitals that did not have obstetric units.
When considering closure of obstetric units, the authors determined that rural obstetric units were less likely to close immediately after expansion, but this
effect faded within two years.
"State decisions to expand Medicaid did not alleviate the ongoing challenge of obstetric care access in the US," the authors conclude.
Offsetting the Health Care Industry's Carbon Footprint
In the second episode of The Earth Disease, journalist Jared Downing explores ways that the health care industry is working to curb its carbon footprint.
The authors explain that in order to address social determinants of health, officials will have to operationalize them within a justice-focused data framework.
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