It Doesn't Take A Brain Surgeon

Brain cancer patients who are uninsured died more frequently study finds

/ Author:  / Reviewed by: Joseph V. Madia, MD

(RxWiki News) Brain surgery of any kind is not only intricately complicated to treat, it’s also expensive. A recent study looked at how insurance status affects the outlook for patients with brain cancer.

A new study looking at how patients fared after surgery to remove a brain tumor revealed that uninsured patients were more likely to die in the hospital than were insured patients.

Even after factoring out other medical conditions and health issues, uninsured patients were still more than twice as likely to die as insured patients. 

These researchers added, “This study did not exclude the possibilities that co-morbid conditions are under-diagnosed in uninsured patients. Or that un-insured patients are presented with more advanced stages of the disease.”

"See a specialist if you have questions."

Eric N. Momin, MD, of the Johns Hopkins University School of Medicine in Baltimore, and colleagues studied 28,351 patients aged 18-65 who’d received a craniotomy between January, 1999 and December 2008.

A craniotomy involves removing part of the skull to access the brain.

Researchers divided the patients according to their insurance status – privately insured, Medicaid recipients and uninsured.

The authors wrote, “Uninsured patients who underwent craniotomy for a brain tumor experienced the highest in-hospital mortality. Differences in overall health do not fully account for this disparity."

Twice as many uninsured patients died after the surgery as did insured patients – 2.6 percent vs. 1.3 percent death rate among those with insurance and 2.3 percent for Medicaid patients.

There was no statistically important difference in the mortality rates of patients with Medicaid coverage compared to patients with private insurance.

“Among patients with brain tumors with no other major medical condition, uninsured patients (but not necessarily Medicaid recipients) have higher in-hospital mortality than privately insured patients, a disparity that was pronounced in teaching hospitals. These findings further reinforce prior data indicating insurance-related disparities in medical and surgical settings,” the authors wrote.

In an accompanying editorial, Shawn L. Hervey-Jumper, MD, and Cormac O. Maher, MD, of the University of Michigan, “We commend the authors for shedding light on this difficult problem. As surgeon scientists, much of our attention has focused on tumor biology and surgical technique. It is time that other socioeconomic considerations receive the same attention.” 

This study was published November 19 in Archives of Surgery.

The research was funded by the Doris Duke Charitable Foundation,VSBfonds and the Prins Bernhard Cultuurfonds and the Robert Wood Johnson Foundation. No conflicts of interest were reported.

Reviewed by: 
Review Date: 
November 19, 2012
Last Updated:
November 19, 2012