Inpatient Urologic Surgeries Could Rise Under ACA

Researchers looked at the effect of insurance coverage expansion in Massachusetts.
Researchers looked at the effect of insurance coverage expansion in Massachusetts.

ORLANDO—Insurance expansion under the Affordable Care Act (ACA) could increase the overall rate of inpatient urologic surgery among non-white and low-income patients, according to new study findings presented at the American Urological Association 2014 annual meeting.

Chad Ellimoottil, MD, of Loyola University Chicago Stritch School of Medicine, and fellow researchers looked at 2003-2010 discharge data in Massachusetts, which in 2006 passed a healthcare reform law aimed at providing health insurance for nearly all residents. The researchers used July 2007 as the transition point between pre- and post-reform periods.

“Because the potential impact of the ACA for urological care delivery remains unknown, we used Massachusetts healthcare reform as a natural experiment to estimate the impact,” the researchers wrote in their study abstract.

In about 1.5 million surgeries, they found no difference in the overall rate of inpatient urologic surgery for the entire Massachusetts population, but they did find an 11% increase among non-whites and a 4.8% increase for low-income patients.

At a procedure level, the researchers reported, insurance expansion causes increased rates of partial nephrectomy and inpatient procedures for benign prostatic hyperplasia, but had no effectd on rates of radical prostatectomy, cystectomy, nephrectomy, pyeloplasty, or percutaneous nephrolithotomy.

“These data inform urologists and specialty societies about the potential impact of national insurance expansion for a key aspect of urological care,” the researchers concluded.

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