Surgical Outcomes Worse for People on Medicaid: Study

Chronic health conditions, high smoking rates, need for emergency surgeries some possible reasons why

By Robert Preidt

Wednesday, May 14, 2014

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WEDNESDAY, May 14, 2014 (HealthDay News) -- Surgery patients covered by Medicaid do worse than those with private insurance, according to a new study.

Compared to patients with private insurance, those covered by Medicaid were more than twice as likely to die within a month of surgery. They also had many more emergency operations and two-thirds more complications after surgery, the study found. Those on Medicaid used 50 percent more hospital resources, had longer hospital stays and ended up back in the hospital more often than those with private insurance.

Medicaid patients tended to be younger than those with private insurance, but were twice as likely to smoke. Folks on Medicaid also had higher rates of conditions that make surgery more risky, including diabetes, lung disease and blood vessel blockages.

The findings, published online May 12 in the journal JAMA Surgery, are important because millions of uninsured people will become eligible to enroll in Medicaid programs that 26 states have expanded under the Affordable Care Act, the University of Michigan Medical School researchers said.

The team analyzed data from nearly 14,000 patients, aged 18 to 64, who had surgery in 52 Michigan hospitals over one year and were covered by either Medicaid or private insurance. Patients who also had Medicare coverage or had no insurance weren't included in the study.

The researchers noted that previous studies suggest that many newly insured patients will use their new coverage to seek care for previously untreated conditions, including those that require surgery.

Hospitals often aren't reimbursed for the total cost of caring for Medicaid patients, so these findings also suggest that some hospitals will face financial challenges in coming years, the study authors added.

"If we make the presumption that the new Medicaid-covered patients will fit the mold of what we see now, surgical and inpatient teams must be prepared to provide the care and support they need," study leader and surgical resident Dr. Seth Waits said in a university news release.

"Financially, it may be a double whammy for hospitals, especially those that have the highest percentage of their surgical population covered by Medicaid," he explained.

SOURCE: University of Michigan, news release, May 12, 2014

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