Study: Best Heart Surgery Outcomes from Insured Patients

A study published in the Journal of the American College of Surgeons said Friday that patients who had heart valve replacement surgery who were privately insured had better medical outcomes than the uninsured and Medicaid patients undergoing the same procedure.

As a result, say the researchers, the type of primary insurance should be considered an independent risk factor as patients and doctors weigh risks for surgery, they concluded.

While other studies have been conducted on insurance status as a predictor of disease and the differences in allocation of surgical treatment as a function of the type of insurance a patient has, no study has examined the impact of the type of insurance on patients undergoing cardiac valve procedures. Further, these patients have not been evaluated in a national database, researchers noted.

The study examined 477,932 patients undergoing heart valve operations over a six-year period using discharge data from the Nationwide Inpatient Sample database.

Patients in each payer group had different income and risk factors. After adjusting for risk factors, the type of insurance a patient had remained a highly significant predictor of mortality, they said.

Uninsured and Medicaid status independently increased the risk of in-hospital mortality and the likelihood of complications after the surgery, according to research results. These results held true in spite of socioeconomic status, hospital-related and other factors associated with low-income patient groups, the researchers said.

The study also found that Medicaid patients experienced the longest average hospital stay and highest total costs.

"The study findings indicate that primary payer status should be considered as an independent risk factor during preoperative patient risk evaluation," said the study's lead author, Dr. Damien LaPar of the University of Virginia Health System.

From 2007 to 2008, the number of uninsured Americans rose by 600,000. Patients covered by Medicaid and Medicare, the U.S. government assistance insurance programs, increased by 4.4 million, while the number of Americans covered by private health insurance fell by 1 million, Reuters reports.

In previously published research, patients with Medicaid and uninsured patients experienced worse outcomes than privately insured patients after medical admissions.