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Study shows patients with public insurance have poorer outcomes after lumbar surgery

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SAN FRANCISCO — Among patients who undergo elective lumbar spine surgery, patients who have government health plans are older, more comorbid and have higher rates of unemployment compared to patients with private health insurance, according to a study presented at the American Association of Neurological Surgeons Annual Meeting, here.

“In surgical treatment of low back pathology, bundled payment amounts and benchmarks of quality should be different for public vs. private plans due to the different patient populations with unique risks and differing outcomes,” Saniya Siraj Godil, MD, said.

Godil and colleagues conducted a prospective longitudinal study of 519 patients who underwent elective lumbar surgery at a single medical institution. They collected data on patient demographics, treatment variables, morbidity, patient-reported outcomes and patient satisfaction. Overall, 283 patients had private insurance and 236 patients had public insurance. Researchers found the mean age was higher in the public insurance group. Patients in the public insurance group also had more comorbidities and were more likely to be unemployed.

The number of motion segments involved in lumbar spine surgery was greater for patients with public insurance. There was a significant difference in the types of surgeries between the two groups. Length of surgery and hospital stay was increased for patients with public insurance. The 90-day morbidity rate was also higher for the public insurance group, however, this difference was not statistically significant. Godil said the mean improvement in patient-reported outcomes was higher for patients with private insurance. ─ by Kristine Houck, MA, ELS

Reference:

Godil SS. Paper #711. Presented at: American Association of Neurological Surgeons Annual Meeting; April 5-9, 2014; San Francisco.

Disclosure: Godil has no relevant financial disclosures.