Disparities in Outcomes by Insurance Payer Groups for Patients Undergoing Anterior Cervical Discectomy and Fusion

Study Design. Retrospective, observational study of clinical outcomes at a single institution. Objective. To compare postoperative complication and readmission rates of payer groups in a cohort of patients undergoing anterior cervical discectomy and fusion (ACDF). Summary of Background Data. Studies examining associations between primary payer and outcomes in spine surgery have been equivocal. Methods. Patients at Mount Sinai having undergone ACDF from 2008 to 2016 were queried and assigned to one of five insurance categories: uninsured, managed care, commercial indemnity insurance, Medicare, and Medicaid, with patients in the commercial indemnity group serving as the reference cohort. Multivariable logistic regression equations for various outcomes with the exposure of payer were created, controlling for age, sex, American Society of Anesthesiology Physical Status Classification (ASA Class), the Elixhauser Comorbidity Index, and number of segments fused. A Bonferroni correction was utilized, such that alpha = 0.0125. Results. Two thousand three hundred eighty seven patients underwent ACDF during the time period. Both Medicare (P 
Source: Spine - Category: Orthopaedics Tags: HEALTH SERVICES RESEARCH Source Type: research