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. 2013 Jul 15;38(16):1393-400.
doi: 10.1097/BRS.0b013e3182959b68.

Medicaid status is associated with higher complication rates after spine surgery

Jacques Hacquebord  1 , Amy M Cizik, Sree Harsha Malempati, Mark A Konodi, Richard J Bransford, Carlo Bellabarba, Jens Chapman, Michael J Lee
Affiliations

Medicaid status is associated with higher complication rates after spine surgery

Jacques Hacquebord et al. Spine (Phila Pa 1976). .

Abstract

Study design: Multivariate analysis of prospectively collected registry data.

Objective: To determine the effect of payor status on complication rates after spine surgery.

Summary of background data: Understanding the risk of perioperative complications is an essential aspect in improving patient outcomes. Previous studies have looked at complication rates after spine surgery and factors related to increased perioperative complications. In other areas of medicine, there has been a growing body of evidence gathered to evaluate the role of payor status on outcomes and complications. Several studies have found increased complication rates and inferior outcomes in the uninsured and Medicaid insured.

Methods: The Spine End Results Registry (2003-2004) is a collection of prospectively collected data on all patients who underwent spine surgery at our 2 institutions. Extensive demographic data, including payor status, and medical information were prospectively recorded as described previously by Mirza et al. Medical complications were defined in detail a priori and were prospectively recorded for at least 2 years after surgery. Using univariate and multivariate analysis, we determined risk of postoperative medical complications dependent on payor status.

Results: A total of 1591 patients underwent spine surgery in 2003 and 2004 that met our criteria and were included in our analysis. With the multivariate analysis and by controlling for age, patients whose insurer was Medicaid had a 1.68 odds ratio (95% confidence interval: 1.23-2.29; P = 0.001) of having any adverse event when compared with the privately insured.

Conclusion: After univariate and multivariate analyses, Medicaid insurance status was found to be a risk factor for postoperative complications. This corresponds to an ever-growing body of medical literature that has shown similar trends and raises the concern of underinsurance.

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References

    1. Cassinelli EH, et al. Risk factors for the development of perioperative complications in elderly patients undergoing lumbar decompression and arthrodesis for spinal stenosis: an analysis of 166 patients. Spine. 2007;32:230–235. - PubMed
    1. Lee DY, Lee S-H, Jang J-S. Risk factors for perioperative cardiac complications after lumbar fusion surgery. Neurol. Med. Chir. (Tokyo) 2007;47:495–500. - PubMed
    1. Lee MJ, et al. Risk factors for medical complication after spine surgery: a multivariate analysis of 1,591 patients. Spine J. 2012;12:197–206. - PMC - PubMed
    1. Lee MJ, et al. Risk Factors for Medical Complication After Lumbar Spine Surgery. Spine. 2011;36:1801–1806. - PMC - PubMed
    1. Schoenfeld AJ, Ochoa LM, Bader JO, Belmont PJ., Jr Risk factors for immediate postoperative complications and mortality following spine surgery: a study of 3475 patients from the National Surgical Quality Improvement Program. J Bone Joint Surg Am. 2011;93:1577–1582. - PubMed

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