{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T21:53:48Z","timestamp":1790114028571,"version":"4.0.1"},"reference-count":41,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2024,6,4]],"date-time":"2024-06-04T00:00:00Z","timestamp":1717459200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2024,6,4]],"date-time":"2024-06-04T00:00:00Z","timestamp":1717459200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2024,10]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>The effect of Medicaid expansion as a part of the Affordable Care Act on vestibular schwannoma (VS) incidence overall and in marginalized populations has not yet been elucidated. The goal of this study was to determine if Medicaid expansion was associated with increases in VS incidence overall, as well as in patients of non\u2010white race or in counties of low socioeconomic status (SES).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We performed a difference\u2010in\u2010difference (DiD) analysis from January 1st 2010\u2013December 31st 2017 utilizing the Surveillance, Epidemiology, and End Results (SEER) database. Our DiD method compared the change in VS rate between counties that did and did not expand Medicaid among patients of white and non\u2010white race, in low and high SES counties, before and after expansion.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The study included 17,312 cases across 1020 counties. Medicaid expansion was associated with a 15% increase (incidence rate ratio 95% CI: [11%, 19]) in VS incidence. White populations saw a 10% increase (CI: [1.06, 1.19]), Black populations saw a 20% increase (CI: [1.10, 1.29]), and patients of other races saw a 44% increase in incidence associated with expansion (CI: [1.21, 1.70]). Low SES counties saw an increase in incidence 1.12 times higher than that of high SES counties (CI:[1.04, 1.20]).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Medicaid expansion was associated with increases in VS incidence across populations. Furthermore, this increase was more evident in disadvantaged populations, such as patients of non\u2010white race and those from low SES counties. These findings emphasize the impact of Medicaid expansion on healthcare utilization for VS diagnosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>\n                      3\u2014Retrospective Cohort Study\n                      <jats:italic>Laryngoscope<\/jats:italic>\n                      , 134:4383\u20134388, 2024\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/lary.31517","type":"journal-article","created":{"date-parts":[[2024,6,4]],"date-time":"2024-06-04T06:33:21Z","timestamp":1717482801000},"page":"4383-4388","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["The Association Between Medicaid Expansion and Disparities in Vestibular Schwannoma Incidence"],"prefix":"10.1002","volume":"134","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3811-4196","authenticated-orcid":false,"given":"Alexander S.","family":"Homer","sequence":"first","affiliation":[{"name":"The Warren Alpert Medical School Brown University  Providence Rhode Island U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Viknesh S.","family":"Kasthuri","sequence":"additional","affiliation":[{"name":"The Warren Alpert Medical School Brown University  Providence Rhode Island U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin J.","family":"Homer","sequence":"additional","affiliation":[{"name":"The Warren Alpert Medical School Brown University  Providence Rhode Island U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rishubh","family":"Jain","sequence":"additional","affiliation":[{"name":"The Warren Alpert Medical School Brown University  Providence Rhode Island U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emily K.","family":"Gall","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery Tufts Medical Center  Boston Massachusetts U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathryn Y.","family":"Noonan","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery Tufts Medical Center  Boston Massachusetts U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,6,4]]},"reference":[{"key":"e_1_2_7_2_1","article-title":"How many uninsured are in the coverage gap and how many could be eligible if all states adopted the Medicaid expansion?","author":"Drake 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