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Insurance Type and Surgical-Patient Characteristics in the UPR-Affiliated Hospitals.
Norma I Cruz1, Elvis Santiago1, Beatriz C Figueroa1
1Department of Surgery, School of Medicine, University of Puerto Rico Medical Sciences Campus, San Juan, Puerto Rico.
Puerto Rico Health Sciences Journal
|October 8, 2020
Summary
Surgical patient characteristics significantly differ by health insurance type. Government-insured/uninsured patients underwent more emergency surgeries compared to privately insured individuals.
Area of Science:
- Health Services Research
- Surgical Outcomes
- Health Insurance Analysis
Background:
- Understanding variations in surgical patient demographics and clinical profiles across different health insurance categories is crucial for equitable healthcare delivery.
- Health insurance type can influence access to care, surgical intervention timing, and patient outcomes.
Purpose of the Study:
- To investigate and compare the characteristics of surgical patients based on their health insurance status.
- To identify specific differences in demographics, comorbidities, and surgical procedures among patients with government/no insurance, Medicare, and private insurance.
Main Methods:
- A retrospective analysis of 5,097 surgical cases from the UPR General Surgery Department database (January 1, 2018 - December 31, 2018).
- Data collected included patient age, gender, inpatient/outpatient status, wound classification, surgery type, American Society of Anesthesiology (ASA) scores, and presence of diabetes, smoking, or hypertension.
- Exclusion criteria: trauma cases.
Main Results:
- Significant differences (P<.05) were observed in patient characteristics across insurance types.
- Government-insured/uninsured patients were younger (mean age 41) and had a higher frequency of emergency surgery (18%) compared to privately insured patients (10%).
- Medicare patients were older (mean age 72) with higher rates of diabetes (46%) and hypertension (81%), and frequently presented with ASA scores ≥3 (73%). Privately insured patients predominantly underwent elective surgery (90%) and were more likely to be outpatients (48%).
Conclusions:
- Health insurance type is a significant determinant of surgical patient characteristics and surgical pathway.
- Targeted interventions and resource allocation may be necessary to address disparities observed between different insurance groups, particularly for the government-insured/uninsured population requiring emergency care.
