University of Florida researchers have found brain tumor patients with private insurance tend to fare better than those who are uninsured or who have Medicaid.
Researchers analyzed nationwide data from more than 566,000 hospital admissions involving brain tumor cases from 2002 to 2011.
Their analysis revealed uninsured and Medicaid patients remained hospitalized longer, developed more medical conditions and complications and were 25 percent more likely than patients with private insurance to die during their hospital stay.
Uninsured and Medicaid patients also ended up in nursing homes, rehabilitation centers and hospice care more frequently than patients with private insurance.
Some of the differences in outcomes can be attributed to patients' access to healthcare and a patient's likelihood of early detection, according to lead author Kristopher G. Hooten, MD.
"When private-insurance patients start to have a problem, it gets picked up really fast. They go to a primary doctor, who makes a quick referral to a neurologist or neurosurgeon," said Dr. Hooten. "It's both an access-to-care and a quality-of-care issue before patients are admitted. [Uninsured or Medicaid patients] come in when their brain tumors are more advanced."
Uninsured and Medicaid patients also fare worse than privately insured patients after being hospitalized. Brain tumor patients without private insurance were more prone to certain kinds of infections, postoperative respiratory issues, problems with blood sugar control, pressure ulcers and vascular catheter infections.
According to Dr. Hooten, the different outcomes were not the result of biased treatment on behalf of the hospitals but the fact that Medicaid patients are more likely to have a broader set of medical problems.
The findings of the study are also relevant to how federal agencies compare hospitals' quality.
Senior author of the study Maryam Rahman, MD, suggests hospitals that care for higher-risk Medicaid and uninsured patients be judged differently than those that have more privately insured patients.
"This type of research is important from a global standpoint to understand what goes into quality assessment, how hospitals are ranked based on quality and which patients are potentially high-risk," said Dr. Rahman. "The true benefit is identifying areas of improvement and making things better for patients."
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