Journal
EPIDEMIOLOGY
Volume 32, Issue 3, Pages 327-335Publisher
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/EDE.0000000000001333
Keywords
Durable medical equipment; Electronic health records; Medicaid; Socioeconomic factors; Vulnerable populations
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Funding
- Robert Wood Johnson Foundation [R00ES027023]
- National Institutes of Environmental Health Sciences
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The study found that the prevalence of durable medical equipment rentals has been increasing over time across different age, gender, racial-ethnic, and Medicaid categories, with Medicaid use being closely associated with equipment rental. In addition, area-level sociodemographics were positively associated with the prevalence of equipment rentals.
Background: Duration and number of power outages have increased over time, partly fueled by climate change, putting users of electricity-dependent durable medical equipment (hereafter, durable medical equipment) at particular risk of adverse health outcomes. Given health disparities in the United States, we assessed trends in durable medical equipment rental prevalence and individual- and area-level sociodemographic inequalities. Methods: Using Kaiser Permanente South California electronic health record data, we identified durable medical equipment renters. We calculated annual prevalence of equipment rental and fit hierarchical generalized linear models with ZIP code random intercepts, stratified by rental of breast pumps or other equipment. Results: 243,559 KPSC members rented durable medical equipment between 2008 and 2018. Rental prevalence increased over time across age, sex, racial-ethnic, and Medicaid categories, most by >100%. In adjusted analyses, Medicaid use was associated with increased prevalence and 108 (95% confidence interval [CI] = 99, 117) additional days of equipment rental during the study period. ZIP code-level sociodemographics were associated with increased prevalence of equipment rentals, for example, a 1 SD increase in percent unemployed and
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