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May 2012, Vol 147, No. 5 >

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Invited Critique | May 2012 ONLINE FIRST

Impact of Payer Status on Treatment Options for Acute Cholecystitis: Will Health Care Reform Help Us Close the Gap?:  Comment on “Payer Status and Treatment Paradigm for Acute Cholecystitis”

Raul J. Rosenthal, MD, FASMBS
Arch Surg. 2012;147(5):458-459. doi:10.1001/archsurg.2011.1890.
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The aim of the Greenstein et al1 study was to demonstrate that the Medicaid population has inferior access to undergo a cholecystectomy for acute cholecystitis (AC) when compared with those that have private insurance (PI). Using a Nationwide Inpatient Sample database from 1998 through 2008, the authors reviewed a total of 843 179 patients who had emergent hospitalizations under the diagnosis of AC. Hospitalizations were stratified by primary payer status (Medicaid [n = 219 326] or private [n = 623 853]), and insurance type was analyzed against cholecystectomy in propensity score–matched cohorts. Approximately 200 000 patients were matched in each cohort. The authors arrived at the following results:

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