"If we make the presumption that the new Medicaid-covered patients will fit the mold of what we see now, surgical and inpatient teams must be prepared to provide the care and support they need," says Seth Waits, M.D., a U-M surgical resident who led the analysis. "Financially, it may be a double whammy for hospitals, especially those that have the highest percentage of their surgical population covered by Medicaid."
The authors were surprised by the wide variation between hospitals in the proportion of their surgical cases that were Medicaid-covered patients. More than 61 percent of all operations on people with Medicaid coverage were done at just 20 of the 52 hospitals.
Although the Medicaid patients were on average younger, they were twice as likely to smoke, and had higher rates of conditions that can arise from years of poor health habits and make surgery riskier, including diabetes, lung disease and blockages in their blood vessels.
In the first month after their operations, they had higher rates of complications, and were more than twice as likely to die, than those with private insurance. They needed an average of one more night in the hospital, and were more likely to need to return to the hospital after going home from surgery.
MSQC: Aiming to make surgery better & safer
Waits conducted the study with Darrell Campbell, Jr., M.D., who directs the MSQC and is a surgeon and U-M Health System chief medical officer, and Michael Englesbe, M.D., the MSQC's associate director.
For nearly a decade, the MSQC has used funding from Blue Cross Blue Shield of Michigan to bring together surgical teams from hospitals across Michigan to collect, pool and analyze a wide range of information about surgical care.
The effort has allowed the hospitals to spot opportunities to improve
|Contact: Kara Gavin|
University of Michigan Health System