A study, published in JAMA Surgery, found that, even among the highest-quality hospitals, dually eligible (DE) patients may have poorer outcomes and higher spending.
Little is known about the interplay between hospital quality and disparities in outcomes and spending by social risk. This study sought to assess whether treatment at high-quality hospitals mitigates DE-associated disparities in outcomes and spending for cancer surgery. Retrospective cohort study from January 1, 2014, to December 31, 2018, evaluating inpatient surgery at acute care hospitals.
A total of 119,757 Medicare beneficiaries aged 65 years or older who underwent colectomy, rectal resection, lung resection, or pancreatectomy were evaluated. Data were analyzed between November 1, 2020, and April 30, 2021.
The findings of this study indicate that, even among the highest-quality hospitals, DE patients had poorer outcomes and higher spending. Dually eligible patients were more likely to be discharged to a facility and therefore incurred higher postacute care costs. Although treatment at high-quality hospitals is associated with reduced differences in outcomes, DE patients remain at high risk for adverse postoperative outcomes and increased readmissions and postacute care use.
- Association of Dual Medicare and Medicaid Eligibility With Outcomes and Spending for Cancer Surgery in High-Quality Hospitals. JAMA Surgery. February 23, 2022.