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More surgery in December among US patients with commercial insurance is offset by unrelated but lesser surgery among patients with Medicare insurance.
Dexter, Franklin; Epstein, Richard H; Diez, Christian; Fahy, Brenda G.
Afiliación
  • Dexter F; Department of Anesthesia, University of Iowa, Iowa City, Iowa, USA.
  • Epstein RH; Department of Anesthesiology, Perioperative Medicine and Pain Management, University of Miami Miller School of Medicine, Miami, Florida, USA.
  • Diez C; Department of Anesthesiology, Perioperative Medicine and Pain Management, University of Miami Miller School of Medicine, Miami, Florida, USA.
  • Fahy BG; Department of Anesthesiology, University of Florida College of Medicine, Gainesville, Florida, USA.
Int J Health Plann Manage ; 37(4): 2445-2460, 2022 Jul.
Article en En | MEDLINE | ID: mdl-35484705
STUDY OBJECTIVE: Evaluate whether there is more surgery (in the US State of Florida) at the end of the year, specifically among patients with commercial insurance. DESIGN: Observational cohort study. SETTING: The 712 facilities in Florida that performed inpatient or outpatient elective surgery from January 2010 through December 2019. RESULTS: Among patients with commercial insurance, December had more cases than November (1.108 [1.092-1.125]) or January (1.257 [1.229-1.286]). In contrast, among patients with Medicare insurance (traditional or managed care), December had fewer cases than November (ratio 0.917 [99% confidence interval 0.904-0.930]) or January (0.823 [0.807-0.839]) of the same year. Summing among all cases, December did not have more cases than November (ratio 1.003 [0.992-1.014]) or January (0.998 [0.984-1.013]). Comparing December versus November (January) ratios for cases among patients with commercial insurance to the corresponding ratios for cases among patients with Medicare, years with more commercial insurance cases had more Medicare cases (Spearman rank correlation +0.36 [+0.25], both p < 0.0001). CONCLUSIONS: In the US State of Florida, although some surgeons' procedural workloads may have seasonal variation if they care mostly for patients with one category of insurance, surgical facilities with patients undergoing many procedures will have less variability. Importantly, more commercial insurance cases were not causing Medicare cases to be postponed or vice-versa, providing mechanistic explanation for why forecasts of surgical demand can reasonably be treated as the sum of the independent workloads among many surgeons.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Programas Controlados de Atención en Salud / Medicare Tipo de estudio: Observational_studies Límite: Aged / Humans País/Región como asunto: America do norte Idioma: En Revista: Int J Health Plann Manage Asunto de la revista: PESQUISA EM SERVICOS DE SAUDE / SERVICOS DE SAUDE Año: 2022 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Reino Unido
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Programas Controlados de Atención en Salud / Medicare Tipo de estudio: Observational_studies Límite: Aged / Humans País/Región como asunto: America do norte Idioma: En Revista: Int J Health Plann Manage Asunto de la revista: PESQUISA EM SERVICOS DE SAUDE / SERVICOS DE SAUDE Año: 2022 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Reino Unido