Spinal Surgery Complications More Common in Medicaid Patients: Study
Rate was 68 percent higher than for people with private insurance
Thursday, July 25, 2013
Researchers analyzed data from nearly 1,600 patients who had spinal surgery over two years. About 23 percent of the procedures were paid by Medicaid -- which covers low-income Americans -- and a similar percentage was paid by Medicare, which mainly covers seniors. About 38 percent of the patients had private insurance and the rest of the patients had other sources of insurance or paid for the surgery themselves.
The initial analysis showed that Medicare patients were nearly three times more likely than privately insured patients to have complications after spinal surgery. But after age was taken into account, Medicare coverage was not a significant risk factor for complications, the researchers said.
They found that Medicaid patients had a 68 percent higher rate of complications than patients with private insurance and that the link between Medicaid coverage and increased risk of complications remained strong even after other factors were taken into account, according to the study, which was published in the July 15 issue of the journal Spine.
Other factors associated with an increased risk of complications included heart failure, bleeding disorders, and trauma or infection as the cause of spinal disease, according to a journal news release. The strongest risk factor was the degree of invasiveness of spinal surgery. The risk of complications was 11 times higher for patients in the most-invasive category.
The findings add to growing concern over the often unacknowledged problem of underinsurance, said Dr. Jacques Henri Hacquebord, of the University of Washington, in Seattle, and colleagues.
Underinsured patients may lack needed benefits or services, have limited access to health care or face unreasonable out-of-pocket costs. Low-income patients covered by Medicaid may face any or all of these barriers to care, the researchers said.
Low education and poor understanding of medical conditions and treatment may also be contributing factors, they said.