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The effect of insurance status on outcomes after partial nephrectomy

  • Urology – Original Paper
  • Published:
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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.

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Acknowledgments

Pierre I. Karakiewicz is partially supported by the University of Montreal Health Centre Urology Specialists, Fonds de la Recherche en Sante du Quebec, the University of Montreal Department of Surgery and the University of Montreal Health Centre (CHUM) Foundation.

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Authors and Affiliations

  1. Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Center, 1058, rue St-Denis, Montreal, QC, H2X 3J4, Canada

    Al’a Abdo, Quoc-Dien Trinh, Maxine Sun, Jan Schmitges, Marco Bianchi, Kevin Zorn, Claudio Jeldres, Paul Perrotte & Pierre I. Karakiewicz

  2. Vattikuti Urology Institute, Henry Ford Health System, Detroit, MI, USA

    Quoc-Dien Trinh, Jesse Sammon, Shyam Sukumar, Craig G. Rogers, James O. Peabody & Mani Menon

  3. Martini-Clinic, Prostate Cancer Center Hamburg-Eppendorf, Hamburg, Germany

    Jan Schmitges

  4. Department of Urology, Weill Medical College of Cornell University, New York, NY, USA

    Shahrokh F. Shariat

Authors
  1. Al’a Abdo
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  2. Quoc-Dien Trinh
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  3. Maxine Sun
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  4. Jan Schmitges
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  5. Marco Bianchi
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  8. Shyam Sukumar
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  9. Kevin Zorn
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  10. Claudio Jeldres
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  11. Paul Perrotte
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  13. James O. Peabody
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  14. Mani Menon
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  15. Pierre I. Karakiewicz
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Corresponding author

Correspondence to Al’a Abdo.

Additional information

Al’a Abdo and Quoc-Dien Trinh contributed equally.

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Abdo, A., Trinh, QD., Sun, M. et al. The effect of insurance status on outcomes after partial nephrectomy. Int Urol Nephrol 44, 343–351 (2012). https://doi.org/10.1007/s11255-011-0056-1

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  • DOI: https://doi.org/10.1007/s11255-011-0056-1

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