The Effect of Insurance Status on Surgical Outcomes in Gynecologic Cancer Patients

Abstract

Objective: The aim of this research was to determine the impact of insurance status on 30-day surgical outcomes for the treatment of gynecologic cancer. Materials and Methods: A retrospective cohort study of surgically treated gynecologic oncology patients in a large, prospective, cancer-survivorship cohort from April 2010 to August 2016 was performed. Inclusion criteria were: (1) diagnosis of gynecologic cancer; (2) surgical management of the cancer; and (3) documented insurance status. Primary outcomes were any 30-day postoperative complications (Clavien-Dindo score ‡1) and serious 30-day complications (Clavien-Dindo score ‡2). Exposure of interest was insurance status at time of diagnosis, classified as private (PRI), public (PUB), or no insurance/self-pay (NI/SP). Relative risks (RRs) of postoperative complications were estimated using log binomial regression. Results: Overall, 458 patients met the inclusion criteria, of which 67% (n = 307) had PRI, 25% (n = 116) had PUB, and 8% (n = 35) had NI/SP. After adjusting for body mass index, cancer stage, and surgical approach, there was no difference in risk of any complications between NI/SP and PUB

Does Age Younger Than 65 Affect Clinical Outcomes in Medicare Patients Undergoing Lumbar Fusion?

“…Insurance status is a frequent topic of investigation in surgery patients with outcomes and access to care varying across surgical subspecialties 6–10. Although data on patients younger than 65 with Medicare insurance is lacking, there is more robust data on Medicaid patients.…”

“…5 Insurance status is a frequent topic of investigation in surgery patients with outcomes and access to care varying across surgical subspecialties. [6][7][8][9][10] Although data on patients younger than 65 with Medicare insurance is lacking, there is more robust data on Medicaid patients. Patients undergoing spine surgery with Medicaid have been shown to be less likely to undergo revision procedures despite experiencing worse outcomes, which may be a reflection of treatment modulation by care providers based on insurance status.…”