Literature DB >> 27497887

Insurance status and reportable quality metrics in the cervical spine fusion population.

Joseph E Tanenbaum1, Jacob A Miller2, Vincent J Alentado3, Daniel Lubelski4, Benjamin P Rosenbaum5, Edward C Benzel6, Thomas E Mroz7.   

Abstract

BACKGROUND CONTEXT: The incidence of adverse care quality events among patients undergoing cervical fusion surgery is unknown using the definition of care quality employed by the Centers for Medicare and Medicaid Services (CMS). The effect of insurance status on the incidence of these adverse quality events is also unknown.
PURPOSE: This study determined the incidence of hospital-acquired conditions (HAC) and patient safety indicators (PSI) in patients with cervical spine fusion and analyzed the association between primary payer status and these adverse events. STUDY
DESIGN: This is a retrospective cohort design. PATIENT SAMPLE: All patients in the Nationwide Inpatient Sample (NIS) aged 18 and older who underwent cervical spine fusion from 1998 to 2011 were included. OUTCOME MEASURES: Incidence of HAC and PSI from 1998 to 2011 served as outcome variables.
METHODS: We queried the NIS for all hospitalizations that included a cervical fusion during the inpatient episode from 1998 to 2011. All comparisons were made between privately insured patients and Medicaid or self-pay patients because Medicare enrollment is confounded with age. Incidence of nontraumatic HAC and PSI was determined using publicly available lists of International Classification of Disease, Ninth Revision, Clinical Modification (ICD-9-CM) diagnosis codes. We built logistic regression models to determine the effect of primary payer status on PSI and nontraumatic HAC.
RESULTS: We identified 419,424 hospitalizations with cervical fusion performed during an inpatient episode. The estimated national incidences of nontraumatic HAC and PSI were 0.35% and 1.6%, respectively. After adjusting for patient demographics and hospital characteristics, Medicaid or self-pay patients had significantly greater odds of experiencing one or more HAC (odds ratio [OR] 1.51 95% conflict of interest [CI] 1.23-1.84) or PSI (OR 1.52 95% CI 1.37-1.70) than the privately insured cohort.
CONCLUSIONS: Among patients undergoing inpatient cervical fusion, primary payer status predicts PSI and HAC (both indicators of adverse health-care quality used to determine hospital reimbursement by CMS). As the US health-care system transitions to a value-based payment model, the cause of these disparities must be studied to improve the quality of care delivered to vulnerable patient populations.
Copyright © 2016 Elsevier Inc. All rights reserved.

Entities:  

Keywords:  Affordable Care Act; Cervical fusion; Hospital-acquired condition; Insurance status; NIS; Patient safety indicator

Mesh:

Year:  2016        PMID: 27497887      PMCID: PMC5493958          DOI: 10.1016/j.spinee.2016.08.005

Source DB:  PubMed          Journal:  Spine J        ISSN: 1529-9430            Impact factor:   4.166


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7.  Disparities in the outcomes of lumbar spinal stenosis surgery based on insurance status.

Authors:  Shivanand P Lad; Kevin T Huang; Jacob H Bagley; Matthew A Hazzard; Ranjith Babu; Timothy Ryan Owens; Beatrice Ugiliweneza; Chirag G Patil; Maxwell Boakye
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8.  The Impact of Socioeconomic Status on the Utilization of Spinal Imaging.

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2.  Factors Associated With Extended Length of Stay and 90-Day Readmission Rates Following ACDF.

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4.  Risk Factors of Unplanned Readmission after Anterior Cervical Discectomy and Fusion: A Systematic Review and Meta-Analysis.

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