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Insurance Type Does Not Impact Adverse Outcomes Following Breast Reduction Surgery
Jacquelyn Roth1, Keisha E Montalmant, Brooke Barrow
1From the Icahn School of Medicine at Mount Sinai Hospital, New York, NY.
Background:
Previous literature suggests that treatment delays and poorer baseline health among patients with Medicare and Medicaid, compared to those with private insurance, contribute to worse outcomes across a range of procedures. However, the impact of insurance type on breast reduction surgery remains underexplored. This study evaluates disparities in breast reduction outcomes among patients with private insurance, Medicaid, and Medicare.
Methods:
A retrospective chart review was conducted of patients who had undergone breast reduction surgery between 2019 and 2023. Patient demographics were collected, and medical insurance was categorized as private, Medicare, or Medicaid. Outcomes studied included complications and procedure length. Regression analyses assessed the association between insurance types and postoperative outcomes. Statistical significance was set at P < 0.05.
Results:
Of the 1085 patients included, 627 had private insurance (57.8%), 363 had Medicaid insurance (33.5%), and 95 had Medicare insurance (8.8%). Age, race, ethnicity, and resected tissue weight differed significantly among the groups. Univariate analysis showed that patients with Medicare insurance had higher odds of postoperative infection (OR, 3.48; P = 0.009), and patients with Medicaid insurance had lower odds of complications requiring reoperation (OR, 0.35; P = 0.04). However, neither association remained significant in multivariate analysis. In contrast, operative time was significantly shorter for patients with Medicaid insurance compared to those with private insurance in both univariate (Beta = -10.14; P = 0.003) and multivariate models (Beta = -11.30; P = 0.006).
Conclusion:
While insurance type was not independently associated with postoperative complications following breast reduction surgery, patients with Medicaid insurance experienced significantly shorter operative times, suggesting that insurance type may influence some aspects of intraoperative care, whereas broader social determinants of health likely have a greater impact on postoperative outcomes.
