Abstract Details

Title Does Insurance Status of Patients Treated in a Neurocritical Care Facility Affect the Length of their Hospital Stay? One Hospital’s Experience

Topic Neuro Trauma, Critical Care, and Sports Neurology

Presentation(s) P15 - Poster Session 15 (12:00 PM-1:00 PM)

Poster/Presentation
Number 13-009

Objective To assess whether insurance status affects the hospital and neuroscience ICU lengths of stay for patients presenting to our hospital for treatment of a neurological emergency.

Background Previous studies have indicated that patients with private insurance experience better clinical outcomes than patients with Medicare, Medicaid, or no insurance after treatment for emergent conditions including myocardial infarction and hemorrhagic stroke. However, no study has examined whether the disparity persists in patients whose treatment is conducted in a dedicated neurocritical care setting, previously shown to improve outcomes for neurological emergencies.

Design/Methods We examined an internal quality assurance database detailing the hospital course of patients presenting to the neuroscience ICU (NSICU) with a neurological emergency (e.g. stroke, TBI, SDH, status epilepticus, meningitis). Patients’ primary insurance payer, hospital length of stay, NSICU length of stay, and transfer status were analyzed. Mean lengths of stay across insurance groups were compared with and without stratification by transfer status. Significance was detected using student’s t-tests.

Results We divided patients into private insurance (n=63), Medicare (n=81), Medicaid (n=50) and uninsured (n=26) groups. The average hospital and NSICU lengths of stay for patients with private insurance (hospital 12.1 days, NSICU 6.9 days), Medicare (12.7, 5.8), Medicaid (12.7, 6.9), and no insurance (14.8, 8.1) were not significantly different across groups. Within transferred patient and directly admitted patient groups, insurance was also not predictive of length of stay.

Conclusions In this preliminary data, insurance status did not correlate with a significant difference in hospital or NSICU length of stay across insurance groups. While larger sample sizes may be necessary to detect small differences, it is also possible that treatment in a specialized critical care facility, robust public health resources in our hospital’s urban location, or an overwhelming influence of other clinical variables may mitigate or mask the small effect of insurance.

Authors/Disclosures
Ian Cossentino, BS (Icahn School of Medicine at Mount Sinai) PRESENTER	No disclosure on file
John Liang, MD (Mount Sinai Health System)	Dr. Liang has nothing to disclose.
Neha Dangayach, MD, F�鶹��ýӳ�� (Icahn School of Medicine At Mount Sinai and Mount Sinai Hospital)	Dr. Dangayach has nothing to disclose.
	No disclosure on file

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