ArticlePloS one2014
Insurance status is associated with treatment allocation and outcomes after subarachnoid hemorrhage.
Article in PloS one, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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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.
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Who cites it
5 citing papers in PubMed, 11 citations in OpenAlex.
- Trial
- The Impact of Socioeconomic Status on Decision on Withdrawal of Life-sustaining Treatments in Aneurysmal Subarachnoid Hemorrhage.Neurocritical care · 2025Article
- Sociodemographic biases in a commercial AI model for intracranial hemorrhage detection.Emergency radiology · 2024Article
- Delirium Prediction using Machine Learning Models on Preoperative Electronic Health Records Data.Proceedings. IEEE International Symposium on Bioinformatics and Bioengineering · 2017Article
- Article
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Authors and funding
9 authors at 2 institutions in 1 country.
Funding
Abstract
objectiveSubarachnoid hemorrhage (SAH) is a particularly devastating type of stroke which is responsible for one third of all stroke-related years of potential life lost before age 65. Surgical treatment has been shown to decrease both morbidity and mortality after subarachnoid hemorrhage. We hypothesized that payer status other than private insurance is associated with lower allocation to surgical treatment for patients with SAH and worse outcomes.
designWe examined the association between insurance type and surgical treatment allocation and outcomes for patients with SAH while adjusting for a wide range of patient and hospital factors. We analyzed the Nationwide Inpatient Sample hospital discharge database using survey procedures to produce weighted estimates representative of the United States population. PATIENTS: We studied 21047 discharges, representing a weighted estimate of 102595 patients age 18 and above with a discharge diagnosis of SAH between 2003 and 2008. MEASUREMENTS: Multivariable logistic and generalized linear regression analyses were used to assess for any associations between insurance status and surgery allocation and outcomes. MAIN
resultsDespite the benefits of surgery 66% of SAH patients did not undergo surgical treatment to prevent rebleeding. Mortality was more than twice as likely for patients with no surgical treatment compared to those who received surgery. Medicare patients were significantly less likely to receive surgical treatment.
conclusionsNearly two thirds of patients with SAH don't receive operative care, and Medicare patients were significantly less likely to receive surgical treatment than other patients. Bias against the elderly and those with chronic illness and disability may play a part in these findings. A system of regionalized care for patients presenting with SAH may reduce disparities and improve appropriate allocation to surgical care and deserves prospective study.
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