Three Years Post–Affordable Care Act Sexually Transmitted Disease Clinics Remain Critical Among Vulnerable Populations

Nicky J. Mehtani, Christina Schumacher, Luke E. Johnsen, Adena Greenbaum, C. Patrick Chaulk, Khalil G Ghanem, Jacky Jennings, Kathleen R Page

Research output: Contribution to journalArticle

Abstract

Introduction: The purpose of the study is to examine whether demand for publicly funded sexually transmitted disease clinics changed after Affordable Care Act implementation. Methods: The percentages of total incident sexually transmitted infections in Baltimore City that occurred at publicly funded sexually transmitted disease clinics were compared between the 3 years prior to and following the 2014 Medicaid and private insurance expansions. Risk factors associated with diagnosis at sexually transmitted disease clinics were identified using log binomial regression. Statistical analyses were conducted in May 2017. Results: Post–Affordable Care Act, the relative proportion of total sexually transmitted infection diagnoses increased among private and hospital-affiliated clinics, remained unchanged at sexually transmitted disease clinics, and decreased at federally qualified health centers and other publicly funded programs (p<0.001). Multivariable analysis controlling for age, sex, race, and ethnicity showed an overall decline in the risk of diagnosis at sexually transmitted disease clinics post–Affordable Care Act compared with prior (adjusted relative risk=0.92, 95% CI=0.89, 0.96), but the risk among black and Latino men aged <25 years persisted (relative risk=1.03, 95% CI=0.96, 1.10). Conclusions: The Affordable Care Act increased access to traditional health care, reducing burden on publicly funded programs. However, demand for sexually transmitted disease clinics remains substantial among priority patients. In the healthcare reform era, sexually transmitted disease clinic funding remains critical.

Original languageEnglish (US)
JournalAmerican Journal of Preventive Medicine
DOIs
StateAccepted/In press - Jan 1 2018

Fingerprint

Vulnerable Populations
Sexually Transmitted Diseases
Patient Protection and Affordable Care Act
Baltimore
Private Hospitals
Health Services Accessibility
Health Care Reform
Medicaid
Insurance
Hispanic Americans
Health

ASJC Scopus subject areas

  • Epidemiology
  • Public Health, Environmental and Occupational Health

Cite this

@article{a9d6df3dd0b04167be5648ba81b1c61b,
title = "Three Years Post–Affordable Care Act Sexually Transmitted Disease Clinics Remain Critical Among Vulnerable Populations",
abstract = "Introduction: The purpose of the study is to examine whether demand for publicly funded sexually transmitted disease clinics changed after Affordable Care Act implementation. Methods: The percentages of total incident sexually transmitted infections in Baltimore City that occurred at publicly funded sexually transmitted disease clinics were compared between the 3 years prior to and following the 2014 Medicaid and private insurance expansions. Risk factors associated with diagnosis at sexually transmitted disease clinics were identified using log binomial regression. Statistical analyses were conducted in May 2017. Results: Post–Affordable Care Act, the relative proportion of total sexually transmitted infection diagnoses increased among private and hospital-affiliated clinics, remained unchanged at sexually transmitted disease clinics, and decreased at federally qualified health centers and other publicly funded programs (p<0.001). Multivariable analysis controlling for age, sex, race, and ethnicity showed an overall decline in the risk of diagnosis at sexually transmitted disease clinics post–Affordable Care Act compared with prior (adjusted relative risk=0.92, 95{\%} CI=0.89, 0.96), but the risk among black and Latino men aged <25 years persisted (relative risk=1.03, 95{\%} CI=0.96, 1.10). Conclusions: The Affordable Care Act increased access to traditional health care, reducing burden on publicly funded programs. However, demand for sexually transmitted disease clinics remains substantial among priority patients. In the healthcare reform era, sexually transmitted disease clinic funding remains critical.",
author = "Mehtani, {Nicky J.} and Christina Schumacher and Johnsen, {Luke E.} and Adena Greenbaum and {Patrick Chaulk}, C. and Ghanem, {Khalil G} and Jacky Jennings and Page, {Kathleen R}",
year = "2018",
month = "1",
day = "1",
doi = "10.1016/j.amepre.2018.03.019",
language = "English (US)",
journal = "American Journal of Preventive Medicine",
issn = "0749-3797",
publisher = "Elsevier Inc.",

}

TY - JOUR

T1 - Three Years Post–Affordable Care Act Sexually Transmitted Disease Clinics Remain Critical Among Vulnerable Populations

AU - Mehtani, Nicky J.

AU - Schumacher, Christina

AU - Johnsen, Luke E.

AU - Greenbaum, Adena

AU - Patrick Chaulk, C.

AU - Ghanem, Khalil G

AU - Jennings, Jacky

AU - Page, Kathleen R

PY - 2018/1/1

Y1 - 2018/1/1

N2 - Introduction: The purpose of the study is to examine whether demand for publicly funded sexually transmitted disease clinics changed after Affordable Care Act implementation. Methods: The percentages of total incident sexually transmitted infections in Baltimore City that occurred at publicly funded sexually transmitted disease clinics were compared between the 3 years prior to and following the 2014 Medicaid and private insurance expansions. Risk factors associated with diagnosis at sexually transmitted disease clinics were identified using log binomial regression. Statistical analyses were conducted in May 2017. Results: Post–Affordable Care Act, the relative proportion of total sexually transmitted infection diagnoses increased among private and hospital-affiliated clinics, remained unchanged at sexually transmitted disease clinics, and decreased at federally qualified health centers and other publicly funded programs (p<0.001). Multivariable analysis controlling for age, sex, race, and ethnicity showed an overall decline in the risk of diagnosis at sexually transmitted disease clinics post–Affordable Care Act compared with prior (adjusted relative risk=0.92, 95% CI=0.89, 0.96), but the risk among black and Latino men aged <25 years persisted (relative risk=1.03, 95% CI=0.96, 1.10). Conclusions: The Affordable Care Act increased access to traditional health care, reducing burden on publicly funded programs. However, demand for sexually transmitted disease clinics remains substantial among priority patients. In the healthcare reform era, sexually transmitted disease clinic funding remains critical.

AB - Introduction: The purpose of the study is to examine whether demand for publicly funded sexually transmitted disease clinics changed after Affordable Care Act implementation. Methods: The percentages of total incident sexually transmitted infections in Baltimore City that occurred at publicly funded sexually transmitted disease clinics were compared between the 3 years prior to and following the 2014 Medicaid and private insurance expansions. Risk factors associated with diagnosis at sexually transmitted disease clinics were identified using log binomial regression. Statistical analyses were conducted in May 2017. Results: Post–Affordable Care Act, the relative proportion of total sexually transmitted infection diagnoses increased among private and hospital-affiliated clinics, remained unchanged at sexually transmitted disease clinics, and decreased at federally qualified health centers and other publicly funded programs (p<0.001). Multivariable analysis controlling for age, sex, race, and ethnicity showed an overall decline in the risk of diagnosis at sexually transmitted disease clinics post–Affordable Care Act compared with prior (adjusted relative risk=0.92, 95% CI=0.89, 0.96), but the risk among black and Latino men aged <25 years persisted (relative risk=1.03, 95% CI=0.96, 1.10). Conclusions: The Affordable Care Act increased access to traditional health care, reducing burden on publicly funded programs. However, demand for sexually transmitted disease clinics remains substantial among priority patients. In the healthcare reform era, sexually transmitted disease clinic funding remains critical.

UR - http://www.scopus.com/inward/record.url?scp=85047222999&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85047222999&partnerID=8YFLogxK

U2 - 10.1016/j.amepre.2018.03.019

DO - 10.1016/j.amepre.2018.03.019

M3 - Article

C2 - 29776778

AN - SCOPUS:85047222999

JO - American Journal of Preventive Medicine

JF - American Journal of Preventive Medicine

SN - 0749-3797

ER -