Disparities in inpatient costs and outcomes after elective anterior cervical discectomy and fusion at safety-net hospitals

•Safety-net hospitals in the United States had greater inpatient costs in performing elective ACDF.•Safety-net hospitals did not have greater LOS in performing elective ACDF.•Safety-net hospitals did not have greater inpatient adverse events after elective ACDF. Characterizing disparities that exist...

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Bibliographic Details
Published in:Clinical neurology and neurosurgery 2020-11, Vol.198, p.106223-106223, Article 106223
Main Authors: Bhandarkar, Archis R., Alvi, Mohammed Ali, Naessens, James M., Bydon, Mohamad
Format: Article
Language:English
Subjects:
Catheters
Central nervous system diseases
Costs
Elective ACDF
Health care policy
Health policy
Hospitals
Infections
Medicaid
Mortality
Neurology
Neurosurgery
Patient safety
Patients
Safety
Safety-net hospitals
Spinal cord
Surgical site infections
Variables
Vertebrae
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Summary:•Safety-net hospitals in the United States had greater inpatient costs in performing elective ACDF.•Safety-net hospitals did not have greater LOS in performing elective ACDF.•Safety-net hospitals did not have greater inpatient adverse events after elective ACDF. Characterizing disparities that exist at safety-net hospitals is crucial for crafting national healthcare reform policies. Healthcare disparities in performing elective neurosurgical procedures like anterior cervical discectomy and fusion (ACDF) at safety-net hospitals have not yet been examined. We use the National Inpatient Sample (NIS), a national all-payer healthcare database of inpatient admissions, to determine whether safety-net hospitals can provide equitable care after elective ACDF. The NIS from 2002 to 2011 was queried for patients who received ACDF in the context of degenerative spine disease. Hospital safety-net burden was designated as low (LBH), medium (MBH), or high (HBH) based on the proportion of inpatient admissions that were billed as Medicaid, self-pay, or charity care. Significance was set at p 
ISSN:0303-8467
1872-6968
DOI:10.1016/j.clineuro.2020.106223