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Health See other Health Articles Title: Private Insurance, Better Prostate Surgery Outcome? NEW YORK (Reuters Health) Sep 23 - U.S. men who have surgery for prostate cancer seem to do better if they have private insurance, a new study finds. Among more than 61,000 men who had their prostates removed to treat cancer, 67% were privately insured, about 31% were on Medicare, and just under 2% were on Medicaid. Men with private insurance had fewer complications from surgery and were less likely to die in the hospital. Also, about 5% of men with private insurance received blood transfusions, compared to nearly 8% of men on Medicare and 11% of men covered by Medicaid The overall risk of surgical complications in government-insured patients was also higher, researchers reported online August 25th in Cancer. Thirteen percent of Medicare patients, and 13% of Medicaid patients, had postoperative complications, vs just under 10% of men with private insurance. Few men in the study died, but the risk was higher for those on Medicaid, 0.3% of whom died in the hospital. The reasons for the findings aren't clear, according to lead researcher Dr. Quoc-Dien Trinh at Henry Ford Hospital in Detroit. Even after he and his colleagues adjusted for patient age, race, and overall health, and for some characteristics of the hospitals, private insurance was still independently linked to fewer complications. There may still be other reasons for the connection, Dr. Trinh told Reuters Health in an email. "Yet," he added, "it is quite possible that when everything is accounted for, patients with private insurance just do better." The "why?" is a question for future studies, he said. "What is urgently needed," he added, "are studies designed to identify specific processes that are responsible for the reported disparities." As for the men in the current study, Dr. Trinh said there was no information on the stage of their cancer at diagnosis, or the tumor grade. He added, though, that the findings add another layer to the bigger issue: "Some patients, based on their insurance type, might be receiving sub-optimal surgical care for an overdiagnosed and overtreated disease," he said. The study is not the first to spot differences in surgery outcomes between privately insured and publicly insured patients. Dr. Trinh noted that disparities have also been found when it comes to colorectal surgery, neurosurgery and orthopedic procedures, among others. "At the end of the day," he said, "it is hard to decipher the root causes of this effect, but it is very real and has significance as we approach changes to the healthcare system in the coming years." SOURCE: bit.ly/pigzmC
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