Dysphagia Care in the United States: Examining the Impact of the Affordable Care Act on Access to Care
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| Formato: | Artículo Open Access |
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Wiley
2025
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| _version_ | 1867008952952160257 |
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| author | Robin Zhao Linh He Sara W. Albert Alexandra Li Anaïs Rameau |
| author_facet | Robin Zhao Linh He Sara W. Albert Alexandra Li Anaïs Rameau Robin Zhao Linh He Sara W. Albert Alexandra Li Anaïs Rameau |
| collection | Wiley Open Access |
| contents | Dysphagia Care in the United States: Examining the Impact of the Affordable Care Act on Access to Care Robin Zhao Linh He Sara W. Albert Alexandra Li Anaïs Rameau Otolaryngology–Head and Neck Surgery AbstractObjectiveTo report the odds of dysphagia treatment among adults with self‐reported dysphagia before and after the implementation of the Affordable Care Act (ACA).Study DesignCross‐sectional analysis.SettingNational Health Interview Survey (NHIS).MethodsMultivariate logistic regression.ResultsThis study included 490 million individuals from the 2012 and 2022 NHIS in weighted responses. Among 235 million individuals in 2012, 9.4 million (4.0%) reported dysphagia (median age, 56.0 years; interquartile range [IQR], 40.0‐68.0 years; 60% female). Among 255 million adults in 2022, 15 million (5.9%) reported dysphagia (median age, 58.0 years; IQR, 40.0‐71.0 years; 57% female). After adjusting for sociodemographic factors, adults in 2022 were significantly more likely than those in 2012 to report dysphagia (adjusted odds ratio [aOR], 1.64; CI, 1.43‐1.87). However, there was no significant difference in the odds of reporting dysphagia treatment between 2012 and 2022. Subgroup analyses by age, race and ethnicity, and insurance type also revealed no significant differences when comparing the 2012 and 2022 cohorts. When examining general access to care, adults reporting dysphagia in 2022 were significantly less likely to delay medical care due to the cost compared to adults reporting dysphagia in 2012 (aOR, 0.52; 95% CI, 0.43‐0.62).ConclusionAlthough more adults reported dysphagia in 2022 than in 2012, our results show no significant improvement in access to dysphagia treatment. This suggests that, although the ACA reduced cost‐related barriers, it has not adequately addressed access to dysphagia care.Level of EvidenceIV. 10.1002/ohn.1239 http://onlinelibrary.wiley.com/termsAndConditions#vor |
| doi_str_mv | 10.1002/ohn.1239 |
| format | Artículo Open Access |
| id | wiley_oa_10_1002_ohn_1239 |
| institution | Wiley Open Access |
| license_str_mv | http://onlinelibrary.wiley.com/termsAndConditions#vor |
| publishDate | 2025 |
| publisher | Wiley |
| record_format | wiley_oa |
| spellingShingle | Dysphagia Care in the United States: Examining the Impact of the Affordable Care Act on Access to Care Robin Zhao Linh He Sara W. Albert Alexandra Li Anaïs Rameau Otolaryngology–Head and Neck Surgery Dysphagia Care in the United States: Examining the Impact of the Affordable Care Act on Access to Care Robin Zhao Linh He Sara W. Albert Alexandra Li Anaïs Rameau Otolaryngology–Head and Neck Surgery AbstractObjectiveTo report the odds of dysphagia treatment among adults with self‐reported dysphagia before and after the implementation of the Affordable Care Act (ACA).Study DesignCross‐sectional analysis.SettingNational Health Interview Survey (NHIS).MethodsMultivariate logistic regression.ResultsThis study included 490 million individuals from the 2012 and 2022 NHIS in weighted responses. Among 235 million individuals in 2012, 9.4 million (4.0%) reported dysphagia (median age, 56.0 years; interquartile range [IQR], 40.0‐68.0 years; 60% female). Among 255 million adults in 2022, 15 million (5.9%) reported dysphagia (median age, 58.0 years; IQR, 40.0‐71.0 years; 57% female). After adjusting for sociodemographic factors, adults in 2022 were significantly more likely than those in 2012 to report dysphagia (adjusted odds ratio [aOR], 1.64; CI, 1.43‐1.87). However, there was no significant difference in the odds of reporting dysphagia treatment between 2012 and 2022. Subgroup analyses by age, race and ethnicity, and insurance type also revealed no significant differences when comparing the 2012 and 2022 cohorts. When examining general access to care, adults reporting dysphagia in 2022 were significantly less likely to delay medical care due to the cost compared to adults reporting dysphagia in 2012 (aOR, 0.52; 95% CI, 0.43‐0.62).ConclusionAlthough more adults reported dysphagia in 2022 than in 2012, our results show no significant improvement in access to dysphagia treatment. This suggests that, although the ACA reduced cost‐related barriers, it has not adequately addressed access to dysphagia care.Level of EvidenceIV. 10.1002/ohn.1239 http://onlinelibrary.wiley.com/termsAndConditions#vor |
| title | Dysphagia Care in the United States: Examining the Impact of the Affordable Care Act on Access to Care |
| topic | Otolaryngology–Head and Neck Surgery |
| url | https://aao-hnsfjournals.onlinelibrary.wiley.com/doi/10.1002/ohn.1239 |