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Uninsured patients undergoing craniotomy for brain tumor have higher in-hospital mortality
Date:11/19/2012

CHICAGO Compared to insured patients, uninsured patients have higher in-hospital mortality following surgery for brain tumors, according to a report published in the November issue of Archives of Surgery, a JAMA Network publication.

Research examining insurance-related disparities in patients undergoing surgery for brain tumors has been limited. About 612,000 people in the United States have a diagnosis of a primary brain or central nervous system tumor. Malignant brain tumors cause 13,000 deaths annually and have a five-year survival rate about 35 percent, the authors write in the study background.

Eric N. Momin, M.D., of the Johns Hopkins University School of Medicine, Baltimore, and colleagues used the Nationwide Inpatient Sample from January 1999 through December 2008 to examine whether being uninsured was associated with higher in-hospital postoperative mortality when undergoing surgery. The study included 28,581 patients (ages 18 to 65 years) who underwent a craniotomy and they were studied in three groups: Medicaid recipients, privately insured and uninsured patients.

"Among patients with brain tumors with no other major medical condition, uninsured patients (but not necessarily Medicaid recipients) have higher in-hospital mortality than privately insured patients, a disparity that was pronounced in teaching hospitals. These findings further reinforce prior data indicating insurance-related disparities in medical and surgical settings," the authors comment.

The mortality rate for privately insured patients was 1.3 percent compared with 2.6 percent for uninsured patients and 2.3 percent for Medicaid recipients in an unadjusted statistical analysis. After adjusting for patient characteristics and stratifying (classifying) by hospital in patients with no co-existing illnesses, uninsured patients still had a higher risk of in-hospital death (hazard ratio, 2.62) compared with privately insured patients. In the adjus
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Contact: Stephanie Desmon
sdesmon1@jhmi.edu
410-955-8665
JAMA and Archives Journals
Source:Eurekalert

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