A study, published in JAMA Surgery, examined whether safety net hospitals have poorer outcomes and higher costs associated with common general surgical procedures, such as appendectomies.
The research team performed a retrospective review of all nonfederally funded hospitals in the California state inpatient database that performed appendectomies from Jan. 1, 2005, to Dec. 31, 2011.
They studied a total of 349 hospitals, performing 274,405 appendectomies, and stratified these hospitals based on safety net burden:
● Low-burden hospitals had the lowest quartile of patients who either had Medicaid or were uninsured
● Medium-burden hospitals had the middle two quartiles
● High-burden hospitals had the highest quartile
The study shows high-burden hospitals treated a larger proportion of patients with perforated appendicitis than medium-and low-burden hospitals did.
The likelihood of high-, medium-and low-burden hospitals using laparoscopy varied:
● High-burden hospitals: 51.6 percent
● Medium-burden hospitals: 60.7 percent
● Low-burden hospitals: 71.9 percent
The study shows there were no differences in morbidity, length of stay or cost among high-, medium- and low-burden hospitals.