The Association between Insurance Status and Complications, Length of Stay and Costs for XXXX .

@entity1 @entity407 @entity101 @entity6 @entity28 @entity565 @entity16 @entity4806 @entity260 @entity2112 @entity299
Study Design. Observational cross-sectional population study using national sample of @entity4806 hospital discharges from 2000 through 2009.Objective. To determine whether there is an association between insurance status and in-hospital surgical outcome for @entity4806 @entity1 with @entity2112 .Summary of Background Data. Association between health insurance status and in-hospital surgical outcome following spinal fusion for @entity4806 @entity2112 is unknown.Methods. An analysis of the Healthcare Cost and Utilization Project Kids' Inpatient Database 2000, 2003, 2006, and 2009 was performed. @entity1 aged 0 to <18 years with @entity2112 and no underlying @entity16 who underwent fusion were included. National trends, @entity1 , hospital and surgical characteristics, @entity260 , and associated factors were studied. Univariate analysis and multivariable logistic regressions were used.Results. There were an estimated 19,439 surgeries (Medicaid 4,766 vs. Private 14,673) for @entity4806 @entity2112 from 2000 to 2009 in the U.S. Spinal fusions for @entity4806 @entity2112 steadily increased from 2000 to 2009 by 18.0%. @entity1 with private insurance were more likely to have surgery than Medicaid @entity1 (7.7 vs. 5.9 per 100,000 capita, p = 0.003). @entity1 with private insurance were slightly older than Medicaid @entity1 at the time of surgery (mean age 13.9 vs. 13.4 years, p<0.001). Medicaid @entity1 had higher prevalence of @entity565 (10.8% vs. 7.4%, p<0.001), @entity101 (1.4% vs. 0.4%, p<0.001), @entity407 (0.3% vs. 0.1%, p = 0.01), @entity6 (0.8% vs. 0.3%, p<0.001), and @entity28 (2.6% vs. 1.5%, p<0.001). Medicaid @entity1 underwent more fusions involving >= 9 vertebrae than private @entity1 (43.0% vs. 33.9%, p<0.001). Postoperative in-hospital complications were similar, including neurologic (Medicaid 1.8% vs. Private 1.7%, p = 0.64) and infectious (Medicaid 0.3% vs. Private 0.2%, p = 0.44). Length of stay was longer (6.1 vs. 5.6 days, p<0.001) and hospital costs higher ( 45,443 vs.  41,635, p<0.001) for Medicaid @entity1 . Surgery performed in the South and Midwest regions, older age, and female gender were associated with lower rates of in-hospital neurologic complications, while the presence of @entity299 , @entity28 , and re-fusion were associated with higher rates of in-hospital neurologic complications.Conclusion. Medicaid @entity1 were younger, underwent longer fusions, and had more medical comorbidities than @entity1 with private insurance. However, insurance status was not associated with increased rate of @entity260 .
