Society of University SurgeonsWorse outcomes among uninsured general surgery patients: Does the need for an emergency operation explain these disparities?
Section snippets
Methods
The 2005–2011 Nationwide Inpatient Sample (NIS) was used to conduct a retrospective analysis of payor status and common surgical procedures. The NIS was investigated for all emergent and elective biliary, colorectal, and hernia procedural International Classification of Disease, 9th Edition, Clinical Modification codes, which were chosen based on definitions of Acute Care Surgery (ACS) scope of practice by the American Association for the Surgery of Trauma.7 A list of the procedure codes used
Results
A total of 749,537 patients included in the NIS from 2005 to 2011 met inclusion criteria. The majority of patients, n = 400,162 (53.3%) were included in the group of biliary operations. Colorectal procedures were performed in 189,763 (25.4%), and 159,648 patients (21.3%) had hernia operations. Table I includes demographic data of each of these groups.
Discussion
Our manuscript describes one possible link between payor status and outcomes for patients undergoing emergent operations. We found risk of emergent operation to be high in patients with government coverage and in patients with no insurance compared with patients with private insurance, but we found that major complications were most apparent in the groups with government coverage. This finding contradicts the intuitive notion that patients without insurance are at the greatest disadvantage to
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Supported by the National Institutes of Health/ NIGMS K23GM093112-01 and American College of Surgeons C. James Carrico Fellowship for the study of Trauma and Critical Care.