Does Insurance Status Affect Access to Care Among Ankle Fracture Patients? An Institutional Retrospective Study

Area of Science:

• Orthopedic Surgery
• Health Services Research
• Health Economics

Background:

• Delayed access to care for ankle fractures can escalate complication risks, especially when surgery is needed.
• Medicaid, a vital insurance for low-income individuals, has been linked to delayed healthcare access in other orthopedic conditions.
• Understanding insurance-based disparities in care access is crucial for timely orthopedic treatment.

Purpose of the Study:

• To investigate if patient insurance status influences the timeliness of care for ankle fracture patients.
• To compare access to orthopedic care between patients with private insurance and those with Medicaid.

Main Methods:

• Retrospective cohort study of 311 patients undergoing open reduction and internal fixation for ankle fractures (2008-2018).
• Exclusion of patients with polytrauma, open injuries, Medicare, no insurance, or self-pay.
• Comparison of time intervals (injury-to-first visit, injury-to-surgery) between privately insured and Medicaid patients.

Main Results:

• Medicaid patients experienced significantly longer average times from injury to first appointment (6.2 days vs. 1.2 days) and injury to surgery (16.1 days vs. 8.3 days) compared to privately insured patients (p < .001 for both).
• Statistical analysis confirmed significant delays in accessing care for Medicaid beneficiaries.

Conclusions:

• Medicaid enrollment is associated with significant delays in accessing orthopedic care for ankle fractures.
• Delayed treatment for ankle fractures can potentially increase healthcare costs, resource utilization, and complication rates, negatively impacting patient outcomes.