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212 posters, 10 topics, 5 sessions, 754 authors, 237 institutions

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The AAPS 101st Annual Meeting

29 April – 2 May, 2023 | Chicago, IL

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PC42

The Epidemiology Of Postoperative Catastrophic Health Expenditure In The United States

Poster Presenter

Ali Rae

Authors

Ali Rae, Anam Ehsan, Alan Yang, Hannah Gilder, Niteesh Choudhary, Justin Dimick, Marcella Aslan, Andrea Pusic, Chuan-Chin Huang, Kavitha Ranganathan

Affiliations

Oregon Health & Sciences University, Department of Neurosurgery, Oregon Health & Science University & Program in Global Surgery and Social Change, Harvard Medical School, Brigham and Women's Hospital, Harvard Medical School, Program in Global Surgery and Social Change, Harvard Medical School, Department of Plastic and Reconstructive Surgery, Brigham and Women's Hospital, Harvard Medical School

Part of Topic

Outcomes

Introduction

•Healthcare is the largest source of debt in collection in the United States
•Over 23 million people struggle with medical debt in the U.S despite insurance.
•Catastrophic expenditure (CHE) is a term that describes the negative consequences of unaffordable healthcare.
•Cost of this magnitude decreases one’s ability to afford basic subsistence needs including food and clothing.

Gap in Knowledge:

1.The epidemiological burden of CHE in surgical patients is unknown.
2.Risk factors for CHE in surgical patients remain unclear.

Study Aims:

1. Quantify the epidemiological burden of postoperative CHE in surgical patients.

2. Identify risk factors for CHE among surgical patients.

Methods

•The Medical Expenditure Panel Survey was used to evaluate patients undergoing surgery from 2016-2019.
•Primary outcome: prevalence of postoperative CHE 
•Impact of age, sex, income, and insurance status on CHE was evaluated using multivariate logistic regression.
 
Results
 
•Of 3,573 postoperative patients, 24.9% experienced CHE.
•Low socioeconomic status was significantly associated with higher likelihood of CHE.
•Lowest income patients were 11 times more likely to experience CHE than high-income patients.

  (OR 11.23, 95%CI [8.01-15.75], p<0.001).

•Patients with public insurance were 36% more likely to experience CHE than the privately insured patients.

  (OR 1.36, 95%CI [1.06 –1.76], p<0.001).

•Age, gender, insurance status, and socioeconomic status       were significantly associated with CHE.
 
Conclusion
 

Over 20% of patients struggle with unaffordable out-of-pocket costs after surgery.

Age, insurance status, gender, and income were risk factors significantly associated with CHE.

Social safety net programs targeted towards high-risk groups can mitigate consequences of unaffordable healthcare costs.

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