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Insurance Coverage Type Impacts Hospitalization Patterns Among Patients with Hepatopancreatic Malignancies

  • Rittal Mehta
  • Kota Sahara
  • Katiuscha Merath
  • J. Madison Hyer
  • Diamantis I. Tsilimigras
  • Anghela Z. Paredes
  • Aslam Ejaz
  • Jordan M Cloyd
  • Mary Dillhoff
  • Allan Tsung
  • Timothy M. PawlikEmail author
Original Article

Abstract

Introduction

Disparities in health and healthcare access remain a major problem in the USA. The current study sought to investigate the relationship between patient insurance status and hospital selection for surgical care.

Methods

Patients who underwent liver or pancreatic resection for cancer between 2004 and 2014 were identified in the National Inpatient Sample. The association of insurance status and hospital type was examined.

Results

In total, 22,254 patients were included in the study. Compared with patients with private insurance, Medicaid patients were less likely to undergo surgery at urban non-teaching hospitals (OR = 0.36, 95%CI 0.22–0.59) and urban teaching hospitals (OR = 0.54, 95%CI 0.34–0.84) than rural hospitals. Medicaid patients were less likely to undergo surgery at private investor-owned hospitals (OR = 0.53, 95%CI 0.38–0.73) than private non-profit hospitals. In contrast, uninsured patients were 2.2-fold more likely to go to government-funded hospitals rather than private non-profit hospitals (OR = 2.19, 95%CI 1.76–2.71).

Conclusion

Insurance status was strongly associated with the type of hospital in which patients underwent surgery for liver and pancreatic cancers. Addressing the reasons for inequitable access to different hospital settings relative to insurance status is essential to ensure that all patients undergoing pancreatic or liver surgery receive high-quality surgical care.

Keywords

Insurance Hospital utilization Hepatopancreatic cancer Medicaid 

Notes

Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflict of interest.

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Copyright information

© The Society for Surgery of the Alimentary Tract 2019

Authors and Affiliations

  • Rittal Mehta
    • 1
  • Kota Sahara
    • 1
  • Katiuscha Merath
    • 1
  • J. Madison Hyer
    • 1
  • Diamantis I. Tsilimigras
    • 1
  • Anghela Z. Paredes
    • 1
  • Aslam Ejaz
    • 1
  • Jordan M Cloyd
    • 1
  • Mary Dillhoff
    • 1
  • Allan Tsung
    • 1
  • Timothy M. Pawlik
    • 1
    Email author
  1. 1.Department of Surgery, Division of Surgical OncologyThe Ohio State University Wexner Medical CenterColumbusUSA

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