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Rates of Readmission and Emergency Department Visits of Publicly Versus Commercially Insured Patients in a Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program Accredited Center

BACKGROUND: Patients with governmental insurance are known to utilize the emergency department (ER) at a higher rate and have higher readmission rates than other patients. Twenty percent of our patients are publicly insured. Our objective was to determine if there was a higher rate of readmissions a...

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Autores principales: Clapp, Benjamin, Vivar, Andres, Castro, Christian, Kim, Jisoo, Gamez, Jesus, Dodoo, Christopher, Davis, Brian
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Society of Laparoendoscopic Surgeons 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9135604/
https://www.ncbi.nlm.nih.gov/pubmed/35655472
http://dx.doi.org/10.4293/JSLS.2022.00009
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author Clapp, Benjamin
Vivar, Andres
Castro, Christian
Kim, Jisoo
Gamez, Jesus
Dodoo, Christopher
Davis, Brian
author_facet Clapp, Benjamin
Vivar, Andres
Castro, Christian
Kim, Jisoo
Gamez, Jesus
Dodoo, Christopher
Davis, Brian
author_sort Clapp, Benjamin
collection PubMed
description BACKGROUND: Patients with governmental insurance are known to utilize the emergency department (ER) at a higher rate and have higher readmission rates than other patients. Twenty percent of our patients are publicly insured. Our objective was to determine if there was a higher rate of readmissions and ER visits within 30 days in publicly insured patients. METHODS: Data was analyzed from a single center submitted to the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program Participant Use Data File from January 1, 2015 to December 31, 2018. We added insurance status and described quantitative variables using mean, and standard deviation (SD). These were reported as regression coefficients (RC) and prevalence ratio (PR), along with their 95% confidence interval (CI). P values of less than 5% were considered statistically significant. RESULTS: The overall rate of ER visits, readmissions, and reoperations were 3.5%, 7.4%, and 2.2% respectively. Medicaid and Medicare patients were found to have longer operative times, 62.7 minutes vs 57.5 minutes (p = 0.35). Patients on public insurance had higher adjusted risk of ER visits (PR 1.43, 95% CI: 0.41–5.3; p = 0.58) and readmissions (PR 1.64, 95% CI: 0.76–3.55; p = 0.21) than patients on commercial/self-pay insurance. Re-operations were lower in the publicly insured group (PR 0.93, 95% CI: 0.2–4.7; p = 0.92) than patients on commercial/self-pay insurance. However, these outcomes were not statistically significant. CONCLUSIONS: Publicly insured patients tend to have a higher adjusted risk of ER visits and readmissions but was not statistically significant. The rate of re-operation was slightly lower in publicly insured patients.
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spelling pubmed-91356042022-06-01 Rates of Readmission and Emergency Department Visits of Publicly Versus Commercially Insured Patients in a Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program Accredited Center Clapp, Benjamin Vivar, Andres Castro, Christian Kim, Jisoo Gamez, Jesus Dodoo, Christopher Davis, Brian JSLS Research Article BACKGROUND: Patients with governmental insurance are known to utilize the emergency department (ER) at a higher rate and have higher readmission rates than other patients. Twenty percent of our patients are publicly insured. Our objective was to determine if there was a higher rate of readmissions and ER visits within 30 days in publicly insured patients. METHODS: Data was analyzed from a single center submitted to the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program Participant Use Data File from January 1, 2015 to December 31, 2018. We added insurance status and described quantitative variables using mean, and standard deviation (SD). These were reported as regression coefficients (RC) and prevalence ratio (PR), along with their 95% confidence interval (CI). P values of less than 5% were considered statistically significant. RESULTS: The overall rate of ER visits, readmissions, and reoperations were 3.5%, 7.4%, and 2.2% respectively. Medicaid and Medicare patients were found to have longer operative times, 62.7 minutes vs 57.5 minutes (p = 0.35). Patients on public insurance had higher adjusted risk of ER visits (PR 1.43, 95% CI: 0.41–5.3; p = 0.58) and readmissions (PR 1.64, 95% CI: 0.76–3.55; p = 0.21) than patients on commercial/self-pay insurance. Re-operations were lower in the publicly insured group (PR 0.93, 95% CI: 0.2–4.7; p = 0.92) than patients on commercial/self-pay insurance. However, these outcomes were not statistically significant. CONCLUSIONS: Publicly insured patients tend to have a higher adjusted risk of ER visits and readmissions but was not statistically significant. The rate of re-operation was slightly lower in publicly insured patients. Society of Laparoendoscopic Surgeons 2022 /pmc/articles/PMC9135604/ /pubmed/35655472 http://dx.doi.org/10.4293/JSLS.2022.00009 Text en © 2022 by SLS, Society of Laparoscopic & Robotic Surgeons. https://creativecommons.org/licenses/by-nc-nd/3.0/us/This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial No Derivatives License (http://creativecommons.org/licenses/by-nc-nd/3.0/us/ (https://creativecommons.org/licenses/by-nc-nd/3.0/us/) ), which permits for noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited and is not altered in any way.
spellingShingle Research Article
Clapp, Benjamin
Vivar, Andres
Castro, Christian
Kim, Jisoo
Gamez, Jesus
Dodoo, Christopher
Davis, Brian
Rates of Readmission and Emergency Department Visits of Publicly Versus Commercially Insured Patients in a Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program Accredited Center
title Rates of Readmission and Emergency Department Visits of Publicly Versus Commercially Insured Patients in a Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program Accredited Center
title_full Rates of Readmission and Emergency Department Visits of Publicly Versus Commercially Insured Patients in a Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program Accredited Center
title_fullStr Rates of Readmission and Emergency Department Visits of Publicly Versus Commercially Insured Patients in a Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program Accredited Center
title_full_unstemmed Rates of Readmission and Emergency Department Visits of Publicly Versus Commercially Insured Patients in a Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program Accredited Center
title_short Rates of Readmission and Emergency Department Visits of Publicly Versus Commercially Insured Patients in a Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program Accredited Center
title_sort rates of readmission and emergency department visits of publicly versus commercially insured patients in a metabolic and bariatric surgery accreditation and quality improvement program accredited center
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9135604/
https://www.ncbi.nlm.nih.gov/pubmed/35655472
http://dx.doi.org/10.4293/JSLS.2022.00009
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