Influence of insurance status on the postoperative outcomes of cytoreductive surgery and HIPEC

Background Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS/HIPEC) is increasingly performed for peritoneal surface malignancies but remains associated with significant morbidity. Scant research is available regarding the impact of insurance status on postoperative outcomes....

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Bibliographic Details
Published in:Journal of surgical oncology 2023-03, Vol.127 (4), p.706-715
Main Authors: Kubi, Boateng, Nudotor, Richard, Fackche, Nadege, Rowe, Julian, Cloyd, Jordan M., Ahmed, Ahmed, Grotz, Travis E., Fournier, Keith, Dineen, Sean, Veerapong, Jula, Baumgartner, Joel M., Clarke, Callisia, Patel, Sameer H., Dhar, Vikrom, Lambert, Laura, Abbott, Daniel E., Pokrzywa, Courtney, Raoof, Mustafa, Lee, Byrne, Zaidi, Mohammad Y., Maithel, Shishir K., Johnston, Fabian M., Greer, Jonathan B.
Format: Article
Language:English
Subjects:
Antineoplastic Combined Chemotherapy Protocols - therapeutic use
appendiceal cancer
Appendix
Cancer
Chemotherapy, Cancer, Regional Perfusion - adverse effects
Combined Modality Therapy
Cytoreduction Surgical Procedures - adverse effects
disparities
Gastric cancer
Gastrointestinal cancer
HIPEC
Humans
Hyperthermia, Induced - adverse effects
Hyperthermic Intraperitoneal Chemotherapy
Insurance Coverage
medicaid
medicare
peritoneal surface malignancies
Postoperative period
Retrospective Studies
Survival Rate
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Summary:Background Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS/HIPEC) is increasingly performed for peritoneal surface malignancies but remains associated with significant morbidity. Scant research is available regarding the impact of insurance status on postoperative outcomes. Methods Patients undergoing CRS/HIPEC between 2000 and 2017 at 12 participating sites in the US HIPEC Collaborative were identified. Univariate and multivariate analyses were used to compare the baseline characteristics, operative variables, and postoperative outcomes of patients with government, private, or no insurance. Results Among 2268 patients, 699 (30.8%) had government insurance, 1453 (64.0%) had private, and 116 (5.1%) were uninsured. Patients with government insurance were older, more likely to be non‐white, and comorbid (p 1, and nonhome discharge were factors independently associated with a postoperative complication. Conclusion While there were differences in postoperative outcomes between the three insurance groups on univariate analysis, there was no independent association between insurance status and postoperative complications after CRS/HIPEC.
ISSN:0022-4790
1096-9098
DOI:10.1002/jso.27147