Health Insurance Payer Status Is Associated With Frailty in a Surgical Patient Population: A Retrospective Case...

Area of Science:

• Gerontology
• Health Services Research
• Surgical Outcomes

Background:

• Frailty is a significant predictor of adverse outcomes in surgical patients.
• The relationship between insurance payer status and frailty in thoracic surgery is not well-established.

Purpose of the Study:

• To investigate the association between insurance payer status and frailty in patients undergoing general thoracic surgery.

Main Methods:

• Retrospective analysis of 430 patients undergoing frailty screening (December 2020-December 2022).
• Frailty assessed using Fried's Frailty Phenotype (FFP) and Modified 5-Item Frailty Index (mFI-5).
• Insurance payers categorized as Medicare, Medicaid, or private; multivariable logistic regression used for analysis.

Main Results:

• Patients with Medicare showed higher odds of frailty compared to privately insured patients (FFP: OR 3.17; mFI-5: OR 3.40).
• Medicaid recipients also demonstrated increased odds of frailty based on mFI-5 (OR 3.35).
• Findings were consistent in sensitivity analysis of surgically treated patients.

Conclusions:

• Publicly insured patients in thoracic surgery exhibit greater frailty compared to privately insured individuals.
• Disparities may be linked to healthcare accessibility, coverage limitations, and socioeconomic status.
• Policy interventions addressing social determinants of health are recommended to mitigate these disparities.