Inpatient rehabilitation service utilization and outcomes under US ACA Medicaid expansion.

For hip fracture, patients with no comorbidities experienced significantly lower LOS (− 1.22 days, P < 0.05) and lower FIM score improvement (− 3.69 units, P < 0.05) in expansion states than in non-expansion states after Medicaid expansion, while patients with pre-existing comorbidities experienced a marginally significant increase in LOS (2.43 days, P < 0.10) and no significant changes for functional improvement.

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Lastly, though the estimated differences in LOS and functional improvements associated with the ACA Medicaid expansion were small in the absolute values, they represented almost 6% differences relative to the average value (e.g., 1.76 points lower in functional improvement relative to an average of 28.77 points in total improvement for stroke), which is considered practically significant.

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