For a study, it was determined that health insurance coverage was suggested as a socioeconomic factor influencing clinical outcomes in cystic fibrosis (CF) patients, although the evidence was conflicting and varied with age. Researchers looked at how multiyear patterns of health insurance coverage were related to lung function decrease and related outcomes in adolescents and young people with cystic fibrosis. They used data from the CF Foundation Patient Registry from 2000 to 2015 to divide patients into three groups based on health insurance coverage: continuous private, continuous public, intermittent public, and coverage gaps (ages 12–17 yr, adolescents; 18–23 yr, transitioning to adulthood; and 24–29 yr, young adults). The percentage projected forced expiratory volume in 1 second (FEV1pp) was the primary outcome, modeled using mixed-effects regression.
Outpatient visits, inpatient days for pulmonary exacerbation treatment, bacterial colonization, and body mass index were also measured. They measured Exposures over the previous six years (e.g., ages 6–11 yr), while they measured outcomes over six years (e.g., 12–17 yr). There were 3,365, 2,800, and 1,807 patients in each of the three cohorts. The middle cohort had the highest rate of FEV1pp decline, with patients with the continuous public (3.1/yr; 95% CI, 3.3 to 2.8) or intermittent public (2.4/yr; 95 % CI, 2.6 to 2.2) coverage having a steeper annual decline than patients with continuous private coverage (2.1/yr; 95% CI, 2.2 to 2.0). Discrepancies in outpatient care usage did not explain these differences. Using public insurance during the transition to adulthood was linked to a faster loss in lung function in CF patients. Further research into the role of insurance as a causal element in this decline or as a proxy for other socioeconomic variables is needed.
Reference:www.atsjournals.org/doi/full/10.1513/AnnalsATS.201911-839OC
