Lack of Insurance May Lead to Increased Mortality After Craniotomy

Area of Science:

• Neurosurgery
• Health Services Research
• Health Economics

Background:

• Socioeconomic status (SES) significantly influences healthcare outcomes.
• Previous research highlights insurance's role in surgical results for specific conditions.
• Limited data exists on SES impact in craniotomy patients.

Purpose of the Study:

• To investigate the impact of insurance status on postoperative outcomes in craniotomy patients.
• To analyze differences in adverse events and mortality between insured and uninsured individuals undergoing craniotomy.

Main Methods:

• Retrospective cohort study of 2445 craniotomy patients (2013-2018).
• Collected data on demographics, comorbidities, surgical factors, and 90-day postoperative outcomes.
• Utilized Mann-Whitney U, independent t-tests, and multivariate logistic regression to compare insured vs. uninsured groups.

Main Results:

• 5.4% of patients were uninsured, showing higher unemployment and younger age.
• Uninsured patients had increased prevalence of non-opioid substance use and higher adverse event rates.
• Uninsured status was independently associated with increased 90-day mortality (OR 2.393, p=0.004).

Conclusions:

• Lower socioeconomic status, indicated by lack of insurance, negatively affects craniotomy outcomes.
• Uninsured patients undergoing craniotomy experience significantly higher 90-day mortality.
• Insurance status is a critical determinant of postoperative outcomes and should guide treatment planning.