Abstract

To assess whether insurance type reflects a patient's quality of care following an ACDF procedure, by comparing differences in post-operative complications, readmission rates, reoperation rates, length of hospital stay, and cost of treatment between patients with Medicare versus private insurance.Propensity score matching (PSM) was employed to match patient cohorts insured by Medicare and private insurance in the MarketScan Commercial Claims and Encounters Database (2007-2016). Age, sex, year of operation, geographic region, comorbidities, and operative factors were used to match cohorts of patients undergoing an ACDF procedure.A total of 110,911 patients met the inclusion criteria, of which 97,543 patients (87.9%) were privately insured and 13,368 patients (12.1%) were insured by Medicare. The PSM algorithm matched 7,026 privately insured patients to 7,026 Medicare patients. After matching, there was no significant difference in 90-day post-operative complication rates, length of stay, or reoperation rates between the Medicare and privately insured cohorts. The Medicare group had lower post-operative readmission rates for all time points: 30 days (1.8% vs. 4.6%; p < 0.001), 60 days (2.5% vs. 6.3%; p < 0.001), and 90 days (4.2% vs. 7.7%; p < 0.001). The median payments to physicians were significantly lower for the Medicare group ($3,885 vs. $5,601; p < 0.001).In this study, propensity score matched patients covered by Medicare and private insurance that underwent an ACDF procedure were found to have similar treatment outcomes.

View details for DOI 10.1016/j.wneu.2023.02.129

View details for PubMedID 36871653