Society of University SurgeonsPayer status is related to differences in access and outcomes of abdominal aortic aneurysm repair in the United States*,**
Section snippets
Data source
Patient and provider information regarding AAAs were obtained from the National Inpatient Sample (NIS) database for the time period 1995 to 2000. The NIS is a 20% stratified random sample of all hospital discharges in the United States, which is maintained by the Agency for Healthcare Research and Quality as part of the Healthcare Cost and Utilization Project.6 The study population included all patients with an International Classification of Diseases, Ninth Revision, Clinical Modification
Patient characteristics
After undergoing AAA repair from 1995-2000, 40,610 patients in the NIS were discharged from hospitals; 35,247 patients who were 65 years of age and older were excluded from further study. The mean age of the remaining 5363 patients who were less 65 years of age included for study was 59 ± 4.7 years. Eighty-six percent of the latter patients were men, and 72% were white (Table I).Patients were similar with respect to demographics, except as noted in Table I.
Proportion with rupture
The overall proportion of patients
Discussion
The issue of insurance as a predictor of timely access to health care is based on 3 principles. First, patients without insurance tend to have delayed examination because of the increased financial barriers to their health care. Second, they could have decreased access or delayed surgical referral because of physician-related gate keeping. Third, they may have delayed diagnosis because of hospital or other global health system deterrents to the uninsured.10 The current study is the first to
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Cited by (0)
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Reprint requests: Gilbert R. Upchurch, Jr, MD, 1500 East Medical Center Dr, Taubman Center 2210, Ann Arbor, MI 48109-0329.
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0039-6060/2003/$30.00 + 0