Influence of Health Insurance Expansion on Disparities in the Treatment of Acute Cholecystitis

Annals of Surgery
Andrew P LoehrerMatthew M Hutter

Abstract

To evaluate the impact of the 2006 Massachusetts (MA) health reform on disparities in the management of acute cholecystitis (AC). Immediate cholecystectomy has been shown to be the optimal treatment for AC, yet variation in care persists depending upon insurance status and patient race. How increased insurance coverage impacts these disparities in surgical care is not known. A cohort study of patients admitted with AC in MA and 3 control states from 2001 through 2009 was performed using the Hospital Cost and Utilization Project State Inpatient Databases. We examined all nonelderly white, black, or Latino patients by insurance type and patient race, evaluating changes in the probability of undergoing immediate cholecystectomy and disparities in receiving immediate cholecystectomy before and after Massachusetts health reform. Data from 141,344 patients hospitalized for AC were analyzed. Before the 2006 reform, government-subsidized/self-pay (GS/SP) patients had a 6.6 to 9.9 percentage-point lower (P < 0.001) probability of immediate cholecystectomy in both MA control states. The MA insurance expansion was independently associated with a 2.5 percentage-point increased probability of immediate cholecystectomy for all GS/SP patients...Continue Reading

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Citations

Feb 11, 2016·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Donna Marie L AlvinoZhi Ven Fong
Nov 28, 2015·Journal of the American College of Surgeons·Andrew P LoehrerCristina R Ferrone
Jun 15, 2016·Journal of the American College of Surgeons·Maya J TorainAdil H Haider
Oct 14, 2016·World Journal of Surgery·Ayman Al-JazaeriTareq Aljurf
Jan 26, 2018·The Journal of Trauma and Acute Care Surgery·Michelle G HamelJay J Doucet
Oct 18, 2016·Diseases of the Colon and Rectum·Mariam F EskanderJennifer F Tseng
Dec 12, 2019·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Amanda FazzalariMitchell A Cahan
Nov 20, 2016·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Andrew P LoehrerJohn T Mullen
Sep 19, 2020·Head & Neck·Bharat Akhanda PanugantiPhilip Weissbrod
Feb 9, 2017·Annals of Surgery·Lindsay E KuoRachel R Kelz
Feb 26, 2021·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Thomas R McCartyChristopher C Thompson
Mar 12, 2021·Journal of the American College of Surgeons·Grace F ChaoKevin Y Pei

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