Medicaid Patients At Greater Risk for Surgery Complications, Studies Find

If you’re a low-income resident receiving Medicaid, the insurance for low-income Americans, and you’re considering spinal surgery, you may want to think again. A new study finds that Medicaid patients are at a 68 percent higher risk of suffering complications from spinal surgery than their non-Medicaid counterparts (those on private health insurance or other forms of support).  In other words, Medicaid patients may be receiving only sub-par medical care when under the knife.

Researchers in the study looked at data from nearly 1,600 patients who had spinal surgery over two years.  23 percent of the procedures were Medicaid-funded; a similar percentage were Medicare-funded (mainly covering seniors); and about 38 percent were covered by private insurance or paid for their surgery out of pocket.

Medicaid patients were found to be at a significantly heightened risk for complications that included, among other things, heart failure, bleeding disorders, and trauma or infection as the cause of spinal disease, according to a journal news release. The strongest risk factor was the degree of invasiveness of spinal surgery. The risk of complications was 11 times higher for patients in the most-invasive category.

Greater surgical risks for Medicaid patients 

The results of this study, published in the July 15 issue of the journal Spine, only add more weight to a growing pileof incoming data suggesting that Medicaid patients are suffering worse complications from surgeries than the privately insured. Another study, this one by researchers at the University of Michigan, analyzed the records of nearly 14,000 patients operated on at 52 hospitals in Michigan from July 2012 to June 2013.

The study, published in the journal of JAMA Surgery, made the following discoveries:

• Medicaid patients experienced two-thirds more surgery complications in the month following their operations and were twice as likely to die then those on private insurance.
• Medicaid patients usually required more recovery time in the hospital than the privately insured—and were also more likely to return to the hospital for treatment of complications.
• Medicaid patients required more emergency operations and 50 percent more

Medicaid patients, while typically significantly younger than others surveyed, on the whole exhibited poorer health.

More Medicaid patients, more surgery complications?

When considered together, these two studies are prescient for what they might convey about the millions of uninsured people who will now qualify for Medicaid, thanks to The Affordable Care Act.

Dr. Darrell A. Campbell Jr., who led the Michigan University study and who directs the Michigan Surgical Quality Collaborative that collected and analyzed study data, said: “The Medicaid patients were sicker, and they did not do as well following surgery. They stayed in the hospital longer, and that increases the cost.”

In Michigan alone, nearly half a million new people have qualified for Medicaid coverage in the last year.  The Obama Administration is encouraging more states to expand their Medicaid coverage.

“We supported the expansion of Medicaid because it means that we can get patients into medical care and get them into optimum shape for an operation,” Dr. Campbell said in an interview. “Being a heavy smoker predisposes you to get pneumonia after an operation.

For a diabetic, if blood sugar is out of control, that increases the chances of a wound infection after surgery. If we can address these issues preoperatively, we can cut down the problems we see after an operation.”