The effect of insurance status on outcomes after partial nephrectomy

Background

Privately insured patients may have favorable health outcomes when compared to those covered by federally funded initiatives. This study explored the effect of insurance status on five short-term outcomes after partial nephrectomy (PN).

Methods

Within the Health Care Utilization Project Nationwide Inpatient Sample (NIS), we focused on PNs performed between 1998 and 2007. We tested the rates of in-hospital mortality, blood transfusions, prolonged length of stay, as well as intraoperative and postoperative complications, stratified according to insurance status. Multivariable logistic regression analyses fitted with general estimation equations for clustering among hospitals further adjusted for confounding factors.

Results

Overall, 8,513 PNs were identified. Of those, most patients were privately insured (53.5%), followed by Medicare (37.5%), uninsured (4.6%) and Medicaid (4.4%). Medicare and Medicaid patients had higher rates of transfusions (P?P?P?P?P?=?0.015) and length of stay beyond the median (OR?=?1.4, P?Conclusion Patients with private insurance undergoing PN have better short-term outcomes, when compared to their publicly insured counterparts.