A new study published in Spine examines the disparities in outcomes for anterior cervical discectomy and fusion by payer.
The authors examined data from patients who underwent spinal fusion from 2008 to 2016 at New York City-based Mount Sinai. The study authors divided patients into categories by insurer, including Medicare, Medicaid, uninsured, managed care and commercial insurance. All other factors were controlled for among the 2,387 patients that were included in the study.
Study authors found:
1. Medicare and Medicaid beneficiaries had higher comorbidity burdens than patients with commercial insurance based on American Society of Anesthesiology Class.
2. The patients with managed care and Medicare insurance had on average more segments fused during surgery than patients with commercial insurance.
3. Medicaid beneficiaries had a higher prolonged extubation rate.
4. Medicare beneficiaries had a longer average length of stay than the commercial insurance patients.
5. The patients with Medicaid reported longer 30- and 90-day emergency department visits after surgery than patients with commercial insurance. Managed care patients were more likely to report 40-day readmissions than patients with commercial insurance.
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