July 16, 2013
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Study finds Medicaid-insured spine surgery patients at increased risk for complications

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Medicaid beneficiaries have a higher risk for complications after spine surgery compared with patients who have private insurance, according to recent research published in Spine.

“Just as medical and surgical comorbidity factors should be taken into account when considering the safety of surgery and likelihood of complication, Medicaid status should be considered as well,” Jacques Hacquebord, MD, from the Department of Sports Medicine and Orthopaedic Surgery at the University of Washington Medical Center in Seattle, stated in a press release.

Hacquebord and colleagues prospectively reviewed 1,591 patients from the Spine End Results Registry between 2003 and 2004. The highest number of patients in the study were insured privately (38.3%), but nearly half of the patients were Medicare (23.1%) or Medicaid (23.1%) recipients. Complications were divided into six categories based on whether the patient developed urological, hematological, pulmonary, cardiac, gastrointestinal or neurological adverse events.

For patients with Medicaid coverage, there was a 1.68 odds ratio compared with patients who were privately insured after controlling for age, confounders and effect modifiers in a multivariate analysis.

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The researchers noted that underinsurance was the most likely cause for increased risk of adverse complications, as patients who were underinsured may have limited health care access and high medical payments that may cause them to avoid treatment.

Reference:

Hacquebord J. Spine. 2013;doi:10.1097/BRS.0b013e3182959b68.

Disclosure: This study was funded by grants from the National Institutes of Health and the National Institute of Arthritis and Musculoskeletal and Skin Diseases and from Synthes Spine.