Medical Student University of Connecticut School of Medicine New Britain, Connecticut, United States
Introduction: The Affordable Care Act and Medicaid expansion have been linked to increasing insurance coverage, however, there is concurrent evidence of persistent decreased access for Medicaid patients compared to privately insured patients. This project evaluates the perspectives of neurosurgical residents and orthopedic spine surgery on access, treatment, and outcomes in adult spine patients by insurance type.
Methods: An online survey was sent to all United States neurosurgery residency and orthopedic spine fellowship programs. The questions evaluated trainee perspectives on differences in spine surgery access, treatment, and outcomes between privately insured and Medicaid patients
Results: 60% of the respondents agree or strongly agree that the spine surgery patient population to which they are exposed is racially diverse. 80% perceive their patient population as diverse in terms of socioeconomic status and insurance type. A majority of respondents neither agree or disagree that patients with Medicaid insurance have difficulty in obtaining non-operative spine care (73%) or have a more difficult time obtaining an outpatient appointment with a spine surgeon (67%). 47% of respondents agree or strongly agree that the insurance type of a spine patient, influences their treatment plan. Further, 77% of respondents agree or strongly agree that Medicaid patients have worse postoperative outcomes following spine surgery.
Conclusion : The results from an online survey suggest that neurosurgery residents and orthopedic spine surgery fellows do not perceive a significant difference in spine surgery access for patients with Medicaid versus private insurance. However, respondents do perceive that patients with Medicaid have worse postoperative outcomes compared with privately insured patients.
