International Urology and Nephrology

, Volume 44, Issue 2, pp 343–351

The effect of insurance status on outcomes after partial nephrectomy

Authors

    • Cancer Prognostics and Health Outcomes UnitUniversity of Montreal Health Center
  • Quoc-Dien Trinh
    • Cancer Prognostics and Health Outcomes UnitUniversity of Montreal Health Center
    • Vattikuti Urology Institute, Henry Ford Health System
  • Maxine Sun
    • Cancer Prognostics and Health Outcomes UnitUniversity of Montreal Health Center
  • Jan Schmitges
    • Cancer Prognostics and Health Outcomes UnitUniversity of Montreal Health Center
    • Martini-Clinic, Prostate Cancer Center Hamburg-Eppendorf
  • Marco Bianchi
    • Cancer Prognostics and Health Outcomes UnitUniversity of Montreal Health Center
  • Jesse Sammon
    • Vattikuti Urology Institute, Henry Ford Health System
  • Shahrokh F. Shariat
    • Department of UrologyWeill Medical College of Cornell University
  • Shyam Sukumar
    • Vattikuti Urology Institute, Henry Ford Health System
  • Kevin Zorn
    • Cancer Prognostics and Health Outcomes UnitUniversity of Montreal Health Center
  • Claudio Jeldres
    • Cancer Prognostics and Health Outcomes UnitUniversity of Montreal Health Center
  • Paul Perrotte
    • Cancer Prognostics and Health Outcomes UnitUniversity of Montreal Health Center
  • Craig G. Rogers
    • Vattikuti Urology Institute, Henry Ford Health System
  • James O. Peabody
    • Vattikuti Urology Institute, Henry Ford Health System
  • Mani Menon
    • Vattikuti Urology Institute, Henry Ford Health System
  • Pierre I. Karakiewicz
    • Cancer Prognostics and Health Outcomes UnitUniversity of Montreal Health Center
Urology – Original Paper

DOI: 10.1007/s11255-011-0056-1

Cite this article as:
Abdo, A., Trinh, Q., Sun, M. et al. Int Urol Nephrol (2012) 44: 343. doi:10.1007/s11255-011-0056-1

Abstract

Background

Privately insured patients may have favorable health outcomes when compared to those covered by federally funded initiatives. This study explored the effect of insurance status on five short-term outcomes after partial nephrectomy (PN).

Methods

Within the Health Care Utilization Project Nationwide Inpatient Sample (NIS), we focused on PNs performed between 1998 and 2007. We tested the rates of in-hospital mortality, blood transfusions, prolonged length of stay, as well as intraoperative and postoperative complications, stratified according to insurance status. Multivariable logistic regression analyses fitted with general estimation equations for clustering among hospitals further adjusted for confounding factors.

Results

Overall, 8,513 PNs were identified. Of those, most patients were privately insured (53.5%), followed by Medicare (37.5%), uninsured (4.6%) and Medicaid (4.4%). Medicare and Medicaid patients had higher rates of transfusions (P < 0.001) and overall postoperative complications (P < 0.001). In multivariable analyses, when compared to privately insured patients, Medicaid patients had higher rates of transfusions (OR = 1.91, P < 0.001) and prolonged length of stay (OR = 1.49, P < 0.001). Medicare patients had higher rates of overall postoperative complications (OR = 1.24, P = 0.015) and length of stay beyond the median (OR = 1.4, P < 0.001).

Conclusion

Patients with private insurance undergoing PN have better short-term outcomes, when compared to their publicly insured counterparts.

Keywords

Partial nephrectomyHealth insuranceCancer outcomesRenal massRenal neoplasmsInsurance statusMortalityPostoperative complications

Copyright information

© Springer Science+Business Media, B.V. 2011