ArticleSpine2013
Medicaid status is associated with higher complication rates after spine surgery.
Article in Spine, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
21 citing papers in PubMed, 51 citations in OpenAlex.
- A multifactorial investigation of 90-day readmission risk in thoracolumbar burst fractures: Does surgery play a role?North American Spine Society journal · 2026Article
- Regional trends in perceptions of American Shoulder and Elbow Surgeons towards barriers to access for patients with Medicaid: limited perioperative service access, low patient engagement, and decreased reimbursement are regionally consistent obstacles.JSES reviews, reports, and techniques · 2025Article
- Healthcare disparities in adult and pediatric spinal deformity: a state of the art review.Spine deformity · 2025Review
- The Influence of Hospital Type, Insurance Type, and Patient Income on 30-Day Complication and Readmission Rates Following Lumbar Spine Fusion.Global spine journal · 2025Article
- Payor Type is Associated With Increased Rates of Reoperation and Health-care Utilization Following Unicompartmental Knee Arthroplasty: A National Database Study.Arthroplasty today · 2023Article
- Medicaid Payer Status Is a Predictor of Early Postoperative Pain Following Upper Extremity Procedures.Hand (New York, N.Y.) · 2022Article
- Demographic Predictors of Treatment and Complications for Spinal Disorders: Part 2, Lumbar Spine Trauma.Neurospine · 2021Article
- Does Medicaid payer status affect patient's shoulder outcomes after shoulder arthroplasty?Musculoskeletal surgery · 2021Article
- Low Socioeconomic Status Is Associated With Increased Complication Rates: Are Risk Adjustment Models Necessary in Cervical Spine Surgery?Global spine journal · 2020Article
- Impact of Insurance and Practice Type on Access to Orthopaedic Sports Medicine.Orthopaedic journal of sports medicine · 2020Article
- Factors Associated With Extended Length of Stay and 90-Day Readmission Rates Following ACDF.Global spine journal · 2020Article
- Quantifying the collective influence of social determinants of health using conditional and cluster modeling.PloS one · 2020Observational
- National Incidence of Patient Safety Indicators in the Total Hip Arthroplasty Population.The Journal of arthroplasty · 2017Article
- Association between insurance status and patient safety in the lumbar spine fusion population.The spine journal : official journal of the North American Spine Society · 2017Article
- Disparities in reportable quality metrics by insurance status in the primary spine neoplasm population.The spine journal : official journal of the North American Spine Society · 2017Article
- Insurance status and reportable quality metrics in the cervical spine fusion population.The spine journal : official journal of the North American Spine Society · 2017Article
- Predictors of outcomes and hospital charges following atlantoaxial fusion.The spine journal : official journal of the North American Spine Society · 2016Article
- Complications following primary and revision transsphenoidal surgeries for pituitary tumors.The Laryngoscope · 2015Article
- Complications of primary and revision functional endoscopic sinus surgery for chronic rhinosinusitis.The Laryngoscope · 2014Article
- The patient protection and Affordable Care Act: better coverage, worse access. Will it really improve patient safety?Clinical orthopaedics and related research · 2014Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors at 2 institutions in 1 country.
Funding
Abstract
STUDY
designMultivariate analysis of prospectively collected registry data.
objectiveTo determine the effect of payor status on complication rates after spine surgery. SUMMARY OF BACKGROUND DATA: Understanding the risk of perioperative complications is an essential aspect in improving patient outcomes. Previous studies have looked at complication rates after spine surgery and factors related to increased perioperative complications. In other areas of medicine, there has been a growing body of evidence gathered to evaluate the role of payor status on outcomes and complications. Several studies have found increased complication rates and inferior outcomes in the uninsured and Medicaid insured.
methodsThe Spine End Results Registry (2003-2004) is a collection of prospectively collected data on all patients who underwent spine surgery at our 2 institutions. Extensive demographic data, including payor status, and medical information were prospectively recorded as described previously by Mirza et al. Medical complications were defined in detail a priori and were prospectively recorded for at least 2 years after surgery. Using univariate and multivariate analysis, we determined risk of postoperative medical complications dependent on payor status.
resultsA total of 1591 patients underwent spine surgery in 2003 and 2004 that met our criteria and were included in our analysis. With the multivariate analysis and by controlling for age, patients whose insurer was Medicaid had a 1.68 odds ratio (95% confidence interval: 1.23-2.29; P = 0.001) of having any adverse event when compared with the privately insured.
conclusionAfter univariate and multivariate analyses, Medicaid insurance status was found to be a risk factor for postoperative complications. This corresponds to an ever-growing body of medical literature that has shown similar trends and raises the concern of underinsurance.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.