Date of Award


Document Type


Degree Name

Doctor of Philosophy (PhD)


College of Health Professions

First Advisor

Kit N. Simpson

Second Advisor

Walter J. Jones

Third Advisor

Brandi M. White

Fourth Advisor

James S Zoller


Access to primary care has been a concern for many in the United States; this concern has led to political debates regarding the expansion of health insurance options to ensure access to timely care, especially for traditionally underserved populations. This dissertation examined the impact of Affordable Care Act’s Medicaid expansion on access to primary care, which was measured by the number of preventable hospitalizations due to an ambulatory care sensitive condition. A common access to primary care theoretical model was revised to align with the modern changes in healthcare policy to study the impact of healthcare policy on access to primary care. Hospitalization data from the Healthcare Cost Utilization Project State Inpatient Database were used to identify preventable hospitalizations. Interrupted Time Series were used to evaluate the effect of Medicaid expansion on access to primary care over a four-year period (2012-2015). Findings indicate Medicaid expansion had a minimal impact on populations’ ability to access primary care; however, this impact was not significant. Future research should utilize administrative hospital data for more states over a longer period of time to see if the effect is significant.


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