Data on Cholecystectomy Reported by Researchers at University of California San Diego (UCSD) (Emergency General Surgery and the Gallbladder: the Affordable Care Act’s Impact On Practice Patterns)

2021 JAN 27 (NewsRx) -- By a News Reporter-Staff News Editor at Health Policy and Law Daily -- Investigators publish new report on Surgery - Cholecystectomy. According to news originating from La Jolla, California, by NewsRx correspondents, research stated, “Gallbladder disease frequently requires emergency general surgery (EGS). The Affordable Care Act (ACA) mandated health insurance coverage for all with the intent to improve access to care and decrease morbidity, mortality, and costs.”

Our news journalists obtained a quote from the research from the University of California San Diego (UCSD), “We hypothesize that after the ACA open-enrollment in 2014 the number of EGS cholecystectomies decreased as access to care improved with a shift in EGS cholecystectomies to teaching institutions. A retrospective review of the National Inpatient Sample Database from 2012 to quarter 3 of 2015 was performed. Patients age 18-64, with a nonelective admission for gallbladder disease based on ICD-9 codes, were collected. Outcomes measured included cholecystectomy, complications, mortality, and wage index-adjusted costs. The effect of the ACA was determined by comparing preACA to postACA years. 189,023 patients were identified. In the postACA period the payer distribution for admissions decreased for Self-pay (19.3% to 13.6%, P< 0.001), Medicaid increased (26.3% to 34.0%, P< 0.001) and Private insurance was unchanged (48.6% to 48.7%, P = 0.946). PostACA, admissions to teaching hospitals increased across all payer types, EGS cholecystectomies decreased, while complications increased, and mortality was unchanged. Median costs increased significantly for Medicaid and Private insurance while Self-pay was unchanged. Based on adjusted DID analyses for Insured compared to Self-pay patients, EGS cholecystectomies decreased (-2.7% versus-1.21%, P = 0.033) and median cost increased more rapidly (+$625 versus +$166, P = 0.017). The ACA has changed EGS, shifting the majority of patients to teaching institutions despite insurance type and decreasing the need for EGS cholecystectomy.”

According to the news editors, the research concluded: “The trend toward higher complication rate with increased overall cost requires attention.”

This research has been peer-reviewed.

For more information on this research see: Emergency General Surgery and the Gallbladder: the Affordable Care Act’s Impact On Practice Patterns. Journal of Surgical Research, 2021;257:356-362. Journal of Surgical Research can be contacted at: Elsevier, 525 B St, Ste 1900, San Diego, CA 92101-4495, USA. (Elsevier - www.elsevier.com; Journal of Surgical Research - http://www.journals.elsevier.com/journal-of-surgical-research/)

The news correspondents report that additional information may be obtained from Laura N. Godat, University of California San Diego (UCSD), School of Medicine, Div Trauma Surg Crit Care Burns & Acute Care Surg, Dept. of Surgery, La Jolla, CA 92093, United States. Additional authors for this research include Todd W. Costantini and Jay J. Doucet.

The direct object identifier (DOI) for that additional information is: https://doi.org/10.1016/j.jss.2020.08.013. This DOI is a link to an online electronic document that is either free or for purchase, and can be your direct source for a journal article and its citation.

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