Abstracts

Rationale: Insurance status and/or payor type have frequently been used as a proxy for identifying the socioeconomic status of individuals living in the United States in health services research. Although prior studies have shown insurance status to influence in-patient outcomes after major medical inpatient stays and/or surgeries, its impact on inpatient complications following status epilepticus remains unknown.

Methods: This was a retrospective cohort study carried out using the National Inpatient Sample (NIS) 2005 to 2014 data files. The 2005 to 2014 NIS dataset was queried using International Classification of Diseases 9th Edition (ICD-9) diagnosis code 345.3 to identify patients who underwent an inpatient admission for status epilepticus. Insurance status was categorized into the following groups—private payor, Medicaid, Medicare, uninsured and unknown. Multivariate logistic regression analyses were used to assess whether having Medicaid or Medicare insurance was associated with a difference in complications, as compared to private payors.

Results: A total of 194,323 patients with status epilepticus were included in the study—out of which 49,199 (25.3%) had private insurance, 62,677 (32.3%) had Medicare insurance, 60,921 (31.4%) had Medicaid insurance, 13,028 (6.7%) were self-pay or had no charge, and 8,499 (4.4%) had missing insurance status/information. Following adjustment for patient demographics, hospital characteristics and baseline comorbidities, patients with Medicaid insurance (vs. Private) were more likely to experience urinary tract infections (OR 1.29 [95% CI 1.22-1.35]: p< 0.001), cardiac complications (OR 1.28 [95% CI 1.15-1.42]; p< 0.001), septic complications/sepsis (OR 1.11 [95% CI 1.02-1.22]; p=0.021), pneumonia (OR 1.16 [95% CI 1.09-1.22]; p< 0.001), hematologic complications (OR 1.20 [95% CI 1.04-1.39]; p=0.014), and neurologic complications (OR 1.09 [95% CI 1.02-1.16]; p=0.014), longer length of stay >