Insurance Disparities in Patient Outcomes and Healthcare Resource Utilization Following Neonatal Intraventricular...

Area of Science:

• Pediatric Neurosurgery
• Neonatal Care
• Health Services Research

Background:

• Insurance status is linked to healthcare access and outcomes in pediatric neurosurgery.
• Previous studies show associations with surgical delay and longer hospitalizations for specific conditions.
• This study focuses on newborns with intraventricular hemorrhage (IVH).

Purpose of the Study:

• To investigate the association between insurance status and inpatient adverse events (AEs), length of stay (LOS), and costs.
• To analyze differences in healthcare utilization for newborns with IVH based on insurance type.
• To identify potential healthcare disparities in neonatal neurosurgery care.

Main Methods:

• Retrospective cohort study using the 2016-2019 National Inpatient Sample database.
• Identification of patients with primary diagnosis of intraventricular hemorrhage (IVH) using ICD-10-CM codes.
• Categorization by insurance status (Medicaid vs. Private Insurance) and multivariate logistic regression analysis for LOS and cost.

Main Results:

• Significant demographic differences observed between Medicaid and Private Insurance (PI) cohorts, including race and household income.
• Medicaid patients had a greater mean length of stay (LOS) and higher total cost of admission compared to PI patients.
• Insurance status was not independently associated with increased odds of extended LOS or exorbitant cost.

Conclusions:

• Demographic characteristics, mean LOS, and mean total cost differed significantly between Medicaid and PI patients.
• Findings suggest potential healthcare disparities based on insurance status in neonatal IVH care.
• Further research is needed to understand the independent impact of insurance status on healthcare utilization in this population.