Insurance Status, an Important Predictor of Oral Cancer Surgery Outcomes

Weyh, Ashleigh; Lunday, Lauren; McClure, Shawn A.

doi:10.1016/j.joms.2015.04.028

Cited by 28 publications

(31 citation statements)

References 36 publications

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“…Uninsured patients face even greater barriers to accessing care than Medicaid patients and may therefore present with more advanced neoplasms relative to Medicaid patients. [39] While the present findings identify a disparity in care quality between differently insured patient populations, further research is needed to better understand the causes of this disparity and elucidate interventions to address discrepancies in care. One potential future study could utilize data from single or multi institutional level to characterize the differences amongst Medicaid/selfpay patients and privately insured patients to identify potential drivers of these observed disparities.…”

Section: Association Of Insurance Status With Psi Incidencementioning

confidence: 80%

“…The authors observed that uninsured patients, followed by Medicare and Medicaid patients, were significantly more likely to have an extended length of hospital stay and a higher incidence of postoperative complications compared to privately insured patients. [39] Finally, Kelz et al performed a retrospective cohort study of 13,415 adults admitted for colorectal carcinoma and found that uninsured and Medicaid patients were 22% more likely (95% CI 1.06 -1.40) to develop complications during their hospital admission and were 57% more likely (95% CI 1.01 -2.42) to die postoperatively compared to privately insured patients. [40] While the relationship between insurance status and patient safety has been quantified for pathologies such as head and neck cancer and colorectal cancer, the present study is the first to quantify the association between primary payer status and PSI among patients admitted with primary spinal cord neoplasms.…”

Section: Association Of Insurance Status With Psi Incidencementioning

confidence: 99%

“…[42] Furthermore, Weyh et al demonstrated that uninsured patients with head and neck cancer were significantly more likely to present with Stage III or Stage IV cancer compared to privately insured patients. [39] While the Medicaid and self-pay patient populations were combined in our analysis, analyzing only self-pay patients would have likely resulted in a higher observed relationship between insurance status and odds of experiencing an adverse quality event. Uninsured patients face even greater barriers to accessing care than Medicaid patients and may therefore present with more advanced neoplasms relative to Medicaid patients.…”

Section: Association Of Insurance Status With Psi Incidencementioning

confidence: 99%

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Disparities in Reportable Quality Metrics by Insurance Status in the Primary Spine Neoplasm Population

et al. 2016

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STUDY DESIGN-Retrospective cohort study.BACKGROUND CONTEXT-CMS defines "adverse quality events" as the incidence of certain complications such as post-surgical hematoma and/or iatrogenic pneumothorax during an inpatient stay. Patient safety indicators (PSI) are a means to measure the incidence of these adverse events. When these occur, reimbursement to the hospital decreases. The incidence of adverse quality events among patients hospitalized for primary spinal neoplasms is unknown. Similarly, it is unclear what the impact of insurance status is on adverse care quality among this patient population.

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Section: Association Of Insurance Status With Psi Incidencementioning

confidence: 80%

Section: Association Of Insurance Status With Psi Incidencementioning

confidence: 99%

Section: Association Of Insurance Status With Psi Incidencementioning

confidence: 99%

See 1 more Smart Citation

Disparities in Reportable Quality Metrics by Insurance Status in the Primary Spine Neoplasm Population

et al. 2016

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“…Uninsured patients face even greater barriers to accessing care than Medicaid patients and may therefore present with more advanced neoplasms relative to Medicaid patients. [39] While the present findings identify a disparity in care quality between differently insured patient populations, further research is needed to better understand the causes of this disparity and elucidate interventions to address discrepancies in care. One potential future study could utilize data from single or multi institutional level to characterize the differences amongst Medicaid/self-pay patients and privately insured patients to identify potential drivers of these observed disparities.…”

Section: Discussionmentioning

confidence: 94%

Disparities in reportable quality metrics by insurance status in the primary spine neoplasm population

et al. 2017

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STUDY DESIGN Retrospective cohort study. BACKGROUND CONTEXT CMS defines “adverse quality events” as the incidence of certain complications such as post-surgical hematoma and/or iatrogenic pneumothorax during an inpatient stay. Patient safety indicators (PSI) are a means to measure the incidence of these adverse events. When these occur, reimbursement to the hospital decreases. The incidence of adverse quality events among patients hospitalized for primary spinal neoplasms is unknown. Similarly, it is unclear what the impact of insurance status is on adverse care quality among this patient population. PURPOSE We aimed to determine the incidence of patient safety indicators (PSI) among patients admitted with primary spinal neoplasms, and to determine the association between insurance status and the incidence of PSI in this population. STUDY DESIGN Retrospective cohort design PATIENT SAMPLE All patients, 18 years and older, in the Nationwide Inpatient Sample (NIS) that were hospitalized for primary spine neoplasms from 1998–2011. OUTCOME MEASURES Incidence of PSI from 1998–2011. METHODS The Nationwide Inpatient Sample (NIS) was queried for all hospitalizations with a diagnosis of primary spinal neoplasm during the inpatient episode from 1998–2011. Incidence of PSI was determined using publicly available lists of ICD-9-CM diagnosis codes. Logistic regression models were used to determine the effect of primary payer status on PSI incidence. All comparisons were made between privately insured patients and Medicaid/self-pay patients. RESULTS We identified 6,095 hospitalizations in which a primary spinal neoplasm was recorded during the inpatient episode. We excluded patients younger than 18 years as well as those with “other” or “missing” primary insurance status, leaving 5,880 patients for analysis. After adjusting for patient demographics and hospital characteristics, Medicaid/self-pay patients had significantly greater odds of experiencing one or more PSI (OR 1.81 95% CI 1.11– 2.95) relative to privately insured patients. CONCLUSIONS Among patients hospitalized for primary spinal neoplasms, primary payer status predicts the incidence of PSI, an indicator of adverse healthcare quality used to determine hospital reimbursement by CMS. As reimbursement continues to be intertwined with reportable quality metrics, identifying vulnerable populations is critical to improving patient care.

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“…A previous study (Weyh et al, 2015) showed that uninsured patients, without cancer insurance, had a greater tendency for prolonged hospital stays. This could reflect their general lack of preventive care, increased use of tobacco and alcohol, along with more advanced disease, and delays in initiating treatment.…”

Section: Discussionmentioning

confidence: 95%

Having Private Cancer Insurance in Korea: Gender Differences

Yoo

Noh²,

Kwon³

et al. 2015

Asian Pacific Journal of Cancer Prevention

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Background: As coverage of public insurance is not sufficient to cover diagnosis or treatment of cancer, having private health insurance is important to prepare for unexpected expenses of cancer. The purpose of this study was to assess factors associated with having private cancer insurance, considering gender among the sociodemographic factors and health behavior. Materials and Methods: We used data from the 2011 Korea Health Panel, which included 10,871 participants aged 20 years and older. Socio-demographics, health behavior, and perceived cancer risk were the independent variables and having private cancer insurance was the dependent variable. Multivariable logistic regression analysis was used to identify factors associated with having private cancer insurance. Results: The variables relating to middle age, higher education, higher household income, married men, and the perceived cancer risk groups of 1-10% and 11-30% were significantly associated with having private cancer insurance. Additionally, females who had private non-cancer health insurance were positively associated with the dependent variables (OR=1.36; 95% CI=1.17-1.57). Education, smoking status, exercise, and perceived cancer risk possibility were significantly associated with having private cancer insurance only among women. The men lowered the overall percentages of those having private cancer insurance (OR=0.53, 95% CI=0.45-0.63). Conclusions: We found that there were significant differences between men and women who had private cancer insurance. Women with private cancer insurance are more likely to follow precautionary health behavior than men. This could be interpreted as resulting from masculine ideologies. It is important to make males recognize the seriousness of the cancer risk. In general, household income was highly associated with private cancer insurance. These results reveal an inequity among the buyers of private cancer insurance in terms of economic status level, education level, and health condition.

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Insurance Status, an Important Predictor of Oral Cancer Surgery Outcomes

Cited by 28 publications

References 36 publications

Disparities in Reportable Quality Metrics by Insurance Status in the Primary Spine Neoplasm Population

Disparities in Reportable Quality Metrics by Insurance Status in the Primary Spine Neoplasm Population

Disparities in reportable quality metrics by insurance status in the primary spine neoplasm population

Having Private Cancer Insurance in Korea: Gender Differences

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