Quality of care for patients with brain tumors differs depending on insurance status
Patients with brain tumors have an increased length of stay in hospitals, worse discharge outcomes and increased in-hospital mortality if they have Medicaid or no insurance compared with if they have private insurance. The study was recently published in Neurosurgery [doi: 10.1227/NEU.0000000000000594].
Since the passage of the Patient Protection and Affordable Care Act in March 2010, the authors noted that the federal government has tried to increase the number of people with health insurance and has started monitoring patient safety indicators (PSIs) and hospital-acquired conditions (HACs).
In this study, the authors identified patients with brain tumors and used the Nationwide Inpatient Sample (NIS) database from 2002 to 2011. They said the NIS is the largest all-payer inpatient healthcare database in the U.S. and contains discharge data from one-fifth of all nonfederal hospital admissions.
The study analyzed 548,727 admissions. The average age was 58.7, and patients in the Medicaid/self-pay group were significantly younger than the Medicare and private insurance groups (P < .001).
The authors identified 113,797 PSIs and 15,810 HACs. They estimated that 16.3 percent of patients with a brain tumor had at least one PSI and 2.8 percent had at least one HAC. They noted the incidence of PSI and HAC was greater than the reported rates of patients undergoing craniotomies for unruptured aneurysms or experiencing ischemic strokes.
The most common PSI was postoperative respiratory failure, while other common PSIs were pressure ulcers, deep vein thrombosis/pulmonary embolism and sepsis. The most common HAC was falls and trauma.
Patients in the Medicaid/self-pay group had a higher number of comorbidities compared with those with private insurance. Further, patients with private insurance were more likely to undergo elective admissions and surgeries, while Medicaid and self-pay patients were more likely to be treated in the emergency department.
Executive Editor
Tim Casey joined TriMed Media Group in 2015 as Executive Editor. For the previous four years, he worked as an editor and writer for HMP Communications, primarily focused on covering managed care issues and reporting from medical and health care conferences. He was also a staff reporter at the Sacramento Bee for more than four years covering professional, college and high school sports. He earned his undergraduate degree in psychology from the University of Notre Dame and his MBA degree from Georgetown University.