Inpatient Hospital Outcomes and its Association with Insurance Type Among Pediatric Neurosurgery Trauma Patients

World Neurosurg. 2020 Sep:141:e484-e489. doi: 10.1016/j.wneu.2020.05.214. Epub 2020 Jun 1.

Abstract

Objective: To assess the association of insurance status and inpatient hospital outcomes among a nationally representative population of pediatric trauma neurosurgery patients.

Methods: The 2006, 2009, and 2012 Healthcare Cost and Utilization Project Kids' Inpatient Database was queried for all pediatric neurosurgery patients (birth through 17 years) with primary International Classification of Diseases, Ninth Edition, Clinical Modification, procedure codes for trauma or hematoma.

Results: Self-pay patients were 2.5 times more likely to die during hospitalization. Results also showed that pediatric neurosurgery patients with private insurance had a reduced length of stay and were more likely to have a favorable disposition at discharge.

Conclusions: Insurance status is significantly associated with mortality, length of stay, and favorable discharge disposition among pediatric neurosurgery trauma patients. Further studies are needed to examine the underlying mechanism of the observed associations.

Keywords: Insurance; Length of stay; Mortality; Neurosurgery; Outcomes; Pediatrics.

MeSH terms

  • Adolescent
  • Child
  • Child, Preschool
  • Craniocerebral Trauma / mortality
  • Craniocerebral Trauma / surgery*
  • Female
  • Humans
  • Infant
  • Infant, Newborn
  • Inpatients*
  • Insurance Coverage
  • Insurance, Health*
  • Length of Stay / statistics & numerical data*
  • Male
  • Neurosurgery
  • Neurosurgical Procedures / mortality*
  • Treatment Outcome
  • United States