The December Effect in Pediatric Elective Surgery Utilization: Differences Between Privately and Publicly Insured...

Area of Science:

• Pediatric Surgery
• Health Services Research
• Healthcare Policy

Background:

• Annual deductibles in health insurance may incentivize delaying elective pediatric procedures.
• Understanding insurance-based disparities in surgical timing is crucial for healthcare planning.

Purpose of the Study:

• To investigate differences in December elective surgery utilization between privately and publicly insured children.
• To determine if rising deductibles correlate with increased year-end surgery rates.

Main Methods:

• Analysis of a large cohort (over 1 million) of pediatric patients undergoing 9 common procedures across 9 states (2012-2019).
• Utilized state inpatient and ambulatory surgery databases.
• Employed log-binomial and linear regression models to compare monthly procedure probabilities and temporal trends.

Main Results:

• Privately insured children (56.7%) were 24% more likely than publicly insured children (41.8%) to undergo surgery in December.
• Peak surgery utilization occurred in December for privately insured (10.1%) and June for publicly insured (9.6%) children.
• No significant overall increase in December procedures was observed over time, except for a slight rise in hydrocelectomies for privately insured children.

Conclusions:

• A significant disparity exists, with privately insured children disproportionately undergoing elective surgery in December.
• Despite concerns about high deductibles, the data do not show a trend of increasing year-end surgery rates for most pediatric procedures.