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Evolving Trends in Insurance Coverage of Vascular Surgery Patients in Academic Practice. Ann Vasc Surg 2019 May;57:170-173



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BACKGROUND: Insurance coverage of vascular surgery patients may differ from patients with less chronic surgical pathologies. The goal of this study is to identify trends in insurance status of vascular surgery patients over the last 10 years at a busy academic center.

METHODS: All consecutive patient visits for a vascular procedure from 2006 to 2016 were retrospectively reviewed from a prospectively collected institutional database. Data points included insurance status, procedures performed, and date of admission. The insurance status was categorized as Medicare, Medicaid, and uninsured. Samples were divided between 2006-2009 and 2011-2016 for comparison. Unpaired t-test, chi-squared test, and regression analysis were used to determine significant trends over the study period.

RESULTS: From 2006 to 2016, 6,007 vascular surgery procedures were performed. Procedure volume increased significantly from 1,309 to 4,698 between the 2 timeframes (P < 0.05), whereas the percentage of Medicaid and Medicare patients trended upward but did not achieve significance. There was a significant decrease in the percentage of uninsured patients between the cohorts (5.65% vs. 2.96%, P < 0.05). In 2012, 10.14% of patients were uninsured compared with 2.56% in 2016 (P < 0.05).

CONCLUSIONS: Insurance status affects access to care and subsequent outcomes. In our busy academic center, insurance coverage for vascular surgery has significantly increased over the past decade. The number of Medicaid and Medicare patients has slowly increased, but a significant and continuing decline in uninsured patients was observed. Implementation of the Affordable Care Act during this time period may have played a role in providing coverage for patient needing vascular surgery.

Author List

Dua A, Rothenberg K, Srivastava G, Brown K, Lewis B, Rossi P, Seabrook G, Malinowski M, Wohlauer M, Lee CJ


Brian D. Lewis MD Professor in the Surgery department at Medical College of Wisconsin
Michael Malinowski MD Associate Professor in the Surgery department at Medical College of Wisconsin
Peter J. Rossi MD Chief, Associate Professor in the Surgery department at Medical College of Wisconsin
Gary R. Seabrook MD Chief, Professor in the Surgery department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Databases, Factual
Health Services Accessibility
Insurance Benefits
Insurance Coverage
Insurance, Health
Medically Uninsured
Partnership Practice
Patient Protection and Affordable Care Act
Retrospective Studies
Time Factors
United States
Vascular Surgical Procedures
jenkins-FCD Prod-468 69a93cef3257f26b866d455c1d2b2d0f28382f14