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Invited Critique
May 2012

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”

Author Affiliations

Author Affiliation: Section of Minimally Invasive Surgery, Bariatric Institute, Weston, Florida.

Arch Surg. 2012;147(5):458-459. doi:10.1001/archsurg.2011.1890

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: