Association of Insurance Type With Inpatient Surgical 30-Day Readmissions, Emergency Department Visits/Observation Stays, and Costs

OBJECTIVETo assess the association of Private, Medicare, and Medicaid/Uninsured insurance type with 30-day Emergency Department visits/Observation Stays (EDOS), readmissions, and costs in a safety-net hospital (SNH) serving diverse socioeconomic status patients. SUMMARY BACKGROUND DATAMedicare'...

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Published in:Annals of surgery open 2023-03, Vol.4 (1), p.e235
Main Authors: Jacobs, Michael A., Kim, Jeongsoo, Tetley, Jasmine C., Schmidt, Susanne, Brimhall, Bradley B., Mika, Virginia, Wang, Chen-Pin, Manuel, Laura S., Damien, Paul, Shireman, Paula K.
Format: Article
Language:English
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Summary:OBJECTIVETo assess the association of Private, Medicare, and Medicaid/Uninsured insurance type with 30-day Emergency Department visits/Observation Stays (EDOS), readmissions, and costs in a safety-net hospital (SNH) serving diverse socioeconomic status patients. SUMMARY BACKGROUND DATAMedicare's Hospital Readmission Reduction Program (HRRP) disproportionately penalizes SNHs. METHODSThis retrospective cohort study used inpatient National Surgical Quality Improvement Program (2013-2019) data merged with cost data. Frailty, expanded Operative Stress Score, case status, and insurance type were used to predict odds of EDOS and readmissions, as well as index hospitalization costs. RESULTSThe cohort had 1,477 Private; 1,164 Medicare; and 3,488 Medicaid/Uninsured cases with a patient mean age 52.1 years [SD=14.7] and 46.8% of the cases were performed on male patients. Medicaid/Uninsured (aOR=2.69, CI=2.38-3.05, P
ISSN:2691-3593
2691-3593
DOI:10.1097/AS9.0000000000000235