Do safety-net hospitals provide equitable care after decompressive surgery for acute cauda equina syndrome?

Clinical Neurology and Neurosurgery
Archis R BhandarkarMohamad Bydon

Abstract

Safety-net hospitals provide care to a substantial share of disadvantaged patient populations. Whether disparities exist between safety-net hospitals and their counterparts in performing emergent neurosurgical procedures has not yet been examined. We used the Nationwide Inpatient Sample (NIS), a national all-payer inpatient healthcare database, to determine whether safety-net hospitals provide equitable care after decompressive surgery for acute cauda equina syndrome (CES). The NIS from 2002 to 2011 was queried for patients with a diagnosis of acute CES who received decompressive surgery. Hospital safety-net burden was designated as low (LBH), medium (MBH), or high (HBH) based on the proportion of inpatient admissions that were billed as Medicaid, self-pay, or charity care. Etiologies of CES were classified as degenerative, neoplastic, trauma, and infectious. Significance was defined at p < 0.01. A total of 5607 admissions were included in this analysis. HBHs were more likely than LBHs to treat patients who were Black, Hispanic, on Medicaid, or had a traumatic CES etiology (p < 0.001). After adjusting for patient, hospital, and clinical factors treatment at an HBH was not associated with greater inpatient adverse events (p = 0....Continue Reading

References

May 27, 2014·Spine·Sreeharsha V NandyalaKern Singh
Oct 16, 2015·JAMA Surgery·Richard S HoehnShimul A Shah
May 1, 2017·The Spine Journal : Official Journal of the North American Spine Society·Jai Deep ThakurAnil Nanda
Jul 6, 2017·JAMA Surgery·Roy P WonSteven L Lee
Apr 25, 2018·Journal of Neuro-oncology·Michael G BrandelAlexander A Khalessi
Jul 25, 2018·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Vikrom K DharShimul A Shah
Sep 18, 2020·Clinical Neurology and Neurosurgery·Archis R BhandarkarMohamad Bydon

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