Insurance Status, Wound Complications, and New Paradigms for Evaluating Patient Care.

Cardiac surgery, wound complications, and readmission rates are 3 independent but intersecting areas where social determinants of health impact patient well-being. Residing in “distressed” communities has been reported to increase the risk of operative mortality after coronary artery bypass surgery (CABG). 1 Charles E.J. Mehaffey J.H. Hawkins R.B. et al. Socioeconomic Distressed Communities Index predicts risk-adjusted mortality after cardiac surgery. Ann Thorac Surg. 2019; 107: 1706-1712 Abstract Full Text Full Text PDF PubMed Scopus (53) Google Scholar Surgical site infections, the most serious post-CABG infections being deep sternal wound infections, are more prevalent in patients of lower socioeconomic status and can lead to increased mortality. 2 Feng T.R. White R.S. Gaber-Baylis L.K. et al. Coronary artery bypass graft readmission rates and risk factors: a retrospective cohort study. Int J Surg. 2018; 54: 7-17 Crossref PubMed Scopus (32) Google Scholar ,3 Perezgrovas-Olaria R. Audisio K. Cancelli G. et al. Deep sternal wound infection and mortality in cardiac surgery: a meta-analysis. Ann Thorac Surg. 2023; 115: 272-280 Abstract Full Text Full Text PDF Scopus (5) Google Scholar Moreover, patients with Medicare and Medicaid vs private insurance are more likely to be readmitted after CABG, with wound infection being one of the leading causes. 2 Feng T.R. White R.S. Gaber-Baylis L.K. et al. Coronary artery bypass graft readmission rates and risk factors: a retrospective cohort study. Int J Surg. 2018; 54: 7-17 Crossref PubMed Scopus (32) Google Scholar National Analysis of Sternal Wound Complications and Readmissions After Coronary Bypass SurgeryThe Annals of Thoracic SurgeryVol. 115Issue 5PreviewWound complications are a cause for readmission after cardiac surgery. Health insurance status has been associated with poor postoperative outcomes. We investigate the association between health insurance status and post-CABG wound dehiscence or infection along with 30-day wound-related readmission using a national database. Full-Text PDF