Brain tumor craniotomy outcomes for dual-eligible medicare and medicaid patients: a 10-year nationwide analysis

Introduction Dual-eligible (DE) patients, simultaneous Medicare and Medicaid beneficiaries, have been shown to have poorer clinical outcomes while incurring higher resource utilization. However, neurosurgical oncology outcomes for DE patients are poorly characterized. Accordingly, we examined the im...

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Bibliographic Details
Published in:Journal of neuro-oncology 2022, Vol.156 (2), p.387-398
Main Authors: Tang, Oliver Y., Clarke, Ross A., Rivera Perla, Krissia M., Corcoran Ruiz, Kiara M., Toms, Steven A., Weil, Robert J.
Format: Article
Language:English
Subjects:
Aged
Brain cancer
Brain Neoplasms - surgery
Brain tumors
Clinical Study
Craniotomy
Eligibility Determination
Glioma
Hospital costs
Humans
Medicaid
Medicare
Medicine
Medicine & Public Health
Meningioma
Metastases
Metastasis
Mortality
Neurology
Neurosurgery
Oncology
Patients
Resource utilization
Treatment Outcome
United States
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Summary:Introduction Dual-eligible (DE) patients, simultaneous Medicare and Medicaid beneficiaries, have been shown to have poorer clinical outcomes while incurring higher resource utilization. However, neurosurgical oncology outcomes for DE patients are poorly characterized. Accordingly, we examined the impact of DE status on perioperative outcomes following glioma, meningioma, or metastasis resection. Methods We identified all admissions undergoing a craniotomy for glioma, meningioma, or metastasis resection in the National Inpatient Sample from 2002 to 2011. Assessed outcomes included inpatient mortality, complications, discharge disposition, length of stay (LOS), and hospital costs. Multivariable regression adjusting for 13 patient, severity, and hospital characteristics assessed the association between DE status and outcomes, relative to four reference insurance groups (Medicare-only, Medicaid-only, private insurance, self-pay). Results Of 195,725 total admissions analyzed, 3.0% were dual-eligible beneficiaries (n = 5933). DEs were younger than Medicare admissions ( P  
ISSN:0167-594X
1573-7373
DOI:10.1007/s11060-021-03922-4