"Uninsured patients undergoing craniotomy for a brain tumor experience worse outcomes than privately insured patients, and this difference is pronounced in teaching hospitals. This variation in postoperative outcomes remains unexplained by hospital characteristics, including clustering effects, comorbid disease, or socioeconomic variations," the authors conclude. "This study did not exclude the possibilities that comorbid conditions are underdiagnosed in uninsured patients or that uninsured patients are presenting with more advanced stages of the disease." (
Arch Surg. 2012; 147:1017-1024.)
Editor's Note: Several authors disclosed funding sources. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.
Critique: Is Insurance Status Modifiable Factor in Brain Tumor Outcomes?
In an invited critique, Shawn L. Hervey-Jumper, M.D., and Cormac O. Maher, M.D., of the University of Michigan, Ann Arbor, write: "Although the recognition of differing survival and complication outcomes in the postoperative period based on insurance status is not new, it has not been rigorously studied in neurosurgery patients."
"We commend the authors for shedding light on this difficult problem. As surgeon scientists, much of our attention has focused on tumor biology and surgical technique. It is time that other socioeconomic considerations receive the same attention," they conclude.
(Arch Surg. 2012;147:1025.)
Editor's Note: Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.
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