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CPO Research Looks at Relationship Between Insurance Status and Health Care

Could your health insurance affect your medical care? A study by Dr. Hannah Xu, a resident in the class of 2019, and researchers from the Department of Anesthesiology’s Center for Perioperative Outcomes (CPO), found that among patients undergoing total hip replacement (THR), insurance status can impact healthcare outcomes and serve as a predictor for increased postoperative risks.   

In the study, published September 30 in the Journal of Clinical Anesthesia, researchers reviewed State Inpatient Databases (SID) for patients undergoing THR in California, Florida and New York from 2007 to 2011. They found that patients with Medicaid had more than double the odds of in-hospital mortality after THR compared to patients with private insurance. Medicaid patients also had higher rates of hospital readmission, longer lengths of stay and increased postoperative complications. 

“We were surprised by the extent that health care outcomes were worse for patients with poorer insurance, especially since the Medicaid cohort had the youngest average patient age among all the insurance group, “ said Dr. Xu.

The research, she added, was not intended to target any specific insurance type.

“It would be a misinterpretation of our analysis to criticize Medicaid as inferior to having no insurance at all,” she said. “ Rather, this study highlights larger socioeconomic and health system related issues that still need to be addressed to improve surgical outcomes for all patients.” 

Dr. Xu’s research is part of a multi-project effort by the CPO designed to investigate causes and methods for addressing healthcare disparities in surgical and anesthesia patients. The project is supervised by Dr. Zachary Turnbull, director of the CPO and medical director of performance improvement; Dr. Robert White, who is also a Van Poznak Research Scholar; and Anna Nachamie, operations administrator for the CPO. Dr. Kane Pryor, director of clinical research for the Department of Anesthesiology, also served as a faculty mentor.

Co-authors of the study are Dr. Robert White, Dahniel Sastow, Dr. Michael Andreae, Licia Gaber-Baylis and Dr. Zachary Turnbull.  

Previously, Dr. Xu presented an abstract of her research at the 42nd Annual Meeting of the Association of Regional Anesthesiology and Pain Medicine (ASRA), where it earned a Best of Meeting award.

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