Impact of medicaid expansion on disparities in revascularization in patients hospitalized with acute myocardial infarction

Fig 1. Association between the affordable care act and revascularization after STEMI (age < 65). The solid circles represent the yearly estimates for the revascularization rate in patients hospitalized with a STEMI based on an interrupted time series model after adjusting patient-level and hospital effects, without imposing restrictions on time trends and making no assumptions that time effects were different before or after 2014. The solid line is based instead on a regression discontinuity model which assumes that pre-intervention and post-intervention trends are linear in order to interpret changes in revascularization rates before and after the ACA.

Fig 2. Association between the affordable care act and disparities in revascularization after STEMI (age < 65). The solid circles represent the yearly estimates for the revascularization rate in black and white patients hospitalized with a STEMI based on an interrupted time series (ITS) model after adjusting patient-level and hospital effects, without imposing restrictions on time trends and making no assumptions that time effects were different before or after 2014. The solid lines are based instead on a comparative interrupted time series (CITS) model which assumes that pre-intervention and post-intervention trends are linear in order to interpret changes in revascularization rates before and after Medicaid expansion.

Fig 3. Association between medicaid expansion and disparities in revascularization after STEMI (age < 65). The solid symbols represent the yearly estimates for the revascularization rate in patients hospitalized with a STEMI in non-expansion states and expansion states, respectively, based on an interrupted time series (ITS) model after adjusting patient-level and hospital effects, without imposing restrictions on time trends and making no assumptions that time effects were different before or after 2014. The solid lines are based instead on a comparative interrupted time-series (CITS) model which assumes that pre-intervention and post-intervention trends are linear in order to interpret changes in revascularization rates before and after Medicaid expansion.

Fig 4. Association between the affordable care act and mortality after STEMI (age < 65). The solid circles represent the yearly estimates for the mortality rate in patients hospitalized with a STEMI based on an interrupted time series (ITS) model after adjusting patient-level and hospital effects, without imposing restrictions on time trends and making no assumptions that time effects were different before or after 2014. The solid line is based instead on a regression discontinuity model, and assumes that pre-intervention and post-intervention trends are linear in order to interpret changes in mortality rates before and after the ACA.

Fig 5. Association between medicaid expansion and mortality after STEMI (age < 65). The solid circles represent the yearly estimates for the mortality rate in patients hospitalized with a STEMI based on an interrupted time series (ITS) model after adjusting patient-level and hospital effects, without imposing restrictions on time trends and making no assumptions that time effects were different before or after 2014. The solid lines are based instead on a comparative interrupted time-series (CITS) model but assume that pre-intervention and post-intervention trends are linear in order to interpret changes in mortality rates before and after Medicaid expansion.