Impact of insurance status, hospital ownership type, and children's hospital designation on outcomes for pediatric neurosurgery patients following spasticity procedures in the USA.

Autor: Alayon AL; Charles E. Schmidt College of Medicine, Florida Atlantic University, 777 Glades Rd, Boca Raton, FL, 33431, USA., Hagerty V; Charles E. Schmidt College of Medicine, Florida Atlantic University, 777 Glades Rd, Boca Raton, FL, 33431, USA., Hospedales E; Charles E. Schmidt College of Medicine, Florida Atlantic University, 777 Glades Rd, Boca Raton, FL, 33431, USA., Botros J; Department of Neurosurgery, School of Medicine, University of New Mexico, NM, 87131, Albuquerque, USA., Levene T; Division of Pediatric Surgery, Joe DiMaggio Children's Hospital, 1150 N 35th Ave, Hollywood, FL, 33021, USA., Samuels S; Office of Human Research, Memorial Healthcare System, 4411 Sheridan St, Hollywood, FL, 33021, USA., Spader H; Department of Neurosurgery, School of Medicine, University of New Mexico, NM, 87131, Albuquerque, USA. hspader@salud.unm.edu.; Division of Pediatric Neuroscience, Joe DiMaggio Children's Hospital, 1150 N 35th Ave, Hollywood, FL, 33021, USA. hspader@salud.unm.edu.
Jazyk: angličtina
Zdroj: Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery [Childs Nerv Syst] 2021 Dec; Vol. 37 (12), pp. 3881-3889. Date of Electronic Publication: 2021 Aug 31.
DOI: 10.1007/s00381-021-05317-2
Abstrakt: Purpose: This study aims to examine the relationship between insurance status, hospital ownership type, and children's hospital designation with outcomes for pediatric patients undergoing neurosurgical treatment for spasticity.
Methods: This retrospective cohort study utilized the Healthcare Cost and Utilization Project Kids' Inpatient Database and included 11,916 pediatric patients (≤ 17 years of age) who underwent neurosurgical treatment for spasticity between 2006 and 2012 using ICD-9-CM procedure codes.
Results: Uninsured patients had a significantly shorter hospital length of stay compared to Medicaid patients (-1.42 days, P = 0.030) as did privately insured patients (-0.74 days; P = 0.035). Discharge disposition and inpatient mortality rate were not associated with insurance status. There were no significant associations with hospital ownership type. Free-standing children's hospitals retained patients significantly longer compared to non-children's hospitals (+1.48 days; P = 0.012) and had a significantly higher likelihood of favorable discharge disposition (P = 0.004). Mortality rate was not associated with children's hospital designation.
Conclusion: Pediatric patients undergoing neurosurgical treatment for spasticity were more likely to stay in the hospital longer if they were insured by Medicaid or treated in a free-standing children's hospital. In addition, patients in free standing children's hospitals were more likely to be discharged with a favorable disposition.
(© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)
Databáze: MEDLINE
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