{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,31]],"date-time":"2026-10-31T12:35:50Z","timestamp":1793450150967,"version":"4.5.0"},"reference-count":45,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,12,1]]},"abstract":"<jats:sec>\n<jats:title>OBJECTIVE<\/jats:title>\n<jats:p>Earlier research has demonstrated that social determinants of health (SDoH) impact neurosurgical access and outcomes, but these trends are less characterized for spine tumors relative to intracranial tumors. The authors aimed to elucidate the association between SDoH and outcomes for a nationwide cohort of spine tumor surgery admissions.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>METHODS<\/jats:title>\n<jats:p>The authors identified all admissions with a spine tumor diagnosis in the National Inpatient Sample (NIS) from 2002 to 2019. Four SDoH were analyzed: race and ethnicity, insurance, household income, and safety-net hospital (SNH) treatment. Hospitals in the top quartile of safety-net burden (in terms of percentage of patients receiving Medicaid or uninsured) were categorized as SNHs. Multivariable regression queried the association between 22 variables and 5 perioperative outcomes: mortality, discharge disposition, complications, length of stay (LOS), and hospitalization costs. Interaction term analysis with hospitalization year was used to assess longitudinal changes in outcome disparities. Finally, the authors constructed random forest machine learning models to assess the impact of SDoH variables on prognostic accuracy and to quantify the relative importance of predictors for disposition.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>RESULTS<\/jats:title>\n<jats:p>Of 6,593,392 total admissions with spine tumors, 219,380 (3.3%) underwent surgery. Non-White race (OR 0.80\u20130.91, p &lt; 0.001) and nonprivate insurance (OR 0.76\u20130.83, p &lt; 0.001) were associated with lower odds of receiving surgery. Among surgical admissions, presenting severity, including of myelopathy and plegia, was elevated among non-White, nonprivate insurance, and low-income admissions (all p &lt; 0.001). Black race (OR 0.70, p &lt; 0.001), Medicare (OR 0.70, p &lt; 0.001), Medicaid (OR 0.90, p &lt; 0.001), and lower income (OR 0.88\u20130.93, all p &lt; 0.001) were associated with decreased odds of favorable discharge disposition. Increased LOS and costs were observed among non-White (+6%\u201310% in LOS and +5%\u20139% in costs, both p &lt; 0.001) and Medicaid (+16% in LOS and +6% in costs, both p &lt; 0.001) admissions. SNH treatment was also associated with higher mortality (OR 1.49, p &lt; 0.001) and complication (OR 1.20, p &lt; 0.001) rates. From 2002 to 2019, disposition improved annually for Medicaid patients (OR 1.03 per year, p = 0.022) but worsened for Black patients (OR 0.98 per year, p = 0.046). Random forest models identified household income as the most important predictor of discharge disposition.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>CONCLUSIONS<\/jats:title>\n<jats:p>For spine tumor admissions, SDoH predicted surgical intervention, presenting severity, and perioperative outcomes. Over 2 decades, disparities improved for Medicaid patients but worsened for Black patients. Finally, SDoH significantly improve prognostic accuracy for outcomes after spine tumor surgery. Further study toward ameliorating patient disparities for this population is warranted.<\/jats:p>\n<\/jats:sec>","DOI":"10.3171\/2024.5.spine231081","type":"journal-article","created":{"date-parts":[[2024,8,31]],"date-time":"2024-08-31T01:51:21Z","timestamp":1725069081000},"page":"677-688","source":"Crossref","is-referenced-by-count":9,"title":["Social determinants of health and outcome disparities in spine tumor surgery. Part 1: An analysis of 6.6 million nationwide admissions"],"prefix":"10.3171","volume":"41","author":[{"given":"Oliver Y.","family":"Tang","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Warren Alpert Medical School of Brown University, Providence, Rhode Island;"},{"name":"Department of Neurosurgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cameron","family":"Ayala","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Warren Alpert Medical School of Brown University, Providence, Rhode Island;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joshua R.","family":"Feler","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Warren Alpert Medical School of Brown University, Providence, Rhode Island;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rahul A.","family":"Sastry","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Warren Alpert Medical School of Brown University, Providence, Rhode Island;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ankush I.","family":"Bajaj","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Warren Alpert Medical School of Brown University, Providence, Rhode Island;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Krissia M.","family":"Rivera Perla","sequence":"additional","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery, Johns Hopkins University, Baltimore, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arjun","family":"Ganga","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Warren Alpert Medical School of Brown University, Providence, Rhode Island;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Owen P.","family":"Leary","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Warren Alpert Medical School of Brown University, Providence, Rhode Island;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silas","family":"Monje","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Warren Alpert Medical School of Brown University, Providence, Rhode Island;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph","family":"Madour","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Warren Alpert Medical School of Brown University, Providence, Rhode Island;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deus J.","family":"Cielo","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Warren Alpert Medical School of Brown University, Providence, Rhode Island;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adetokunbo A.","family":"Oyelese","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Warren Alpert Medical School of Brown University, Providence, Rhode Island;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jared S.","family":"Fridley","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Warren Alpert Medical School of Brown University, Providence, Rhode Island;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven A.","family":"Toms","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Warren Alpert Medical School of Brown University, Providence, Rhode Island;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ziya L.","family":"Gokaslan","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Warren Alpert Medical School of Brown University, Providence, Rhode Island;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patricia L.","family":"Zadnik Sullivan","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Warren Alpert Medical School of Brown University, Providence, Rhode Island;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"Suppl 5","key":"b1","series-title":"Neuro Oncol","first-page":"v1","article-title":"CBTRUS Statistical Report: Primary Brain and Other Central Nervous System Tumors Diagnosed in the United States in 2015\u20132019","volume":"24","author":"Ostrom QT","year":"2022","unstructured":"Ostrom QT, Price M, Neff C,  CBTRUS Statistical Report: Primary Brain and Other Central Nervous System Tumors Diagnosed in the United States in 2015\u20132019. Neuro Oncol. 2022;24(Suppl 5):v1\u2013v95."},{"issue":"2","key":"b2","series-title":"J Neurooncol","first-page":"173","article-title":"Descriptive epidemiology of primary spinal cord tumors","volume":"87","author":"Schellinger KA","year":"2008","unstructured":"Schellinger KA, Propp JM, Villano JL, McCarthy BJ. Descriptive epidemiology of primary spinal cord tumors. J Neurooncol. 2008;87(2):173\u2013179."},{"issue":"Suppl 1","key":"b3","series-title":"Neurooncol Pract","first-page":"i5","article-title":"Epidemiology of spinal cord and column tumors","volume":"7","author":"Wewel JT","year":"2020","unstructured":"Wewel JT, O\u2019Toole JE. Epidemiology of spinal cord and column tumors. Neurooncol Pract. 2020;7(Suppl 1):i5\u2013i9."},{"issue":"8","key":"b4","series-title":"N Engl J Med","first-page":"494","article-title":"A randomized trial of surgery in the treatment of single metastases to the brain","volume":"322","author":"Patchell RA","year":"1990","unstructured":"Patchell RA, Tibbs PA, Walsh JW,  A randomized trial of surgery in the treatment of single metastases to the brain. N Engl J Med. 1990;322(8):494\u2013500."},{"key":"b5","series-title":"World Neurosurg","first-page":"e175","article-title":"Racial and ethnic disparities in the inpatient management of primary spinal cord tumors","volume":"140","author":"Chiu RG","year":"2020","unstructured":"Chiu RG, Murphy BE, Zhu A, Mehta AI. Racial and ethnic disparities in the inpatient management of primary spinal cord tumors. World Neurosurg. 2020;140:e175\u2013e184."},{"issue":"4","key":"b6","series-title":"J Neurosurg Spine","first-page":"678","article-title":"Impact of race on nonroutine discharge, length of stay, and postoperative complications after surgery for spinal metastases","volume":"36","author":"Hung B","year":"2021","unstructured":"Hung B, Pennington Z, Hersh AM,  Impact of race on nonroutine discharge, length of stay, and postoperative complications after surgery for spinal metastases. J Neurosurg Spine. 2021;36(4):678\u2013685."},{"key":"b7","series-title":"Cancer Epidemiol","first-page":"101792","article-title":"Racial disparities in clinical presentation, type of intervention, and in-hospital outcomes of patients with metastatic spine disease: an analysis of 145,809 admissions in the United States","volume":"68","author":"De la Garza Ramos R","year":"2020","unstructured":"De la Garza Ramos R, Benton JA, Gelfand Y,  Racial disparities in clinical presentation, type of intervention, and in-hospital outcomes of patients with metastatic spine disease: an analysis of 145,809 admissions in the United States. Cancer Epidemiol. 2020;68:101792."},{"issue":"2","key":"b8","series-title":"Clin Orthop Relat Res","first-page":"301","article-title":"Are there racial or socioeconomic disparities in ambulatory outcome or survival after oncologic spine surgery for metastatic cancer? Results from a medically underserved center","volume":"481","author":"De la Garza Ramos R","year":"2023","unstructured":"De la Garza Ramos R, Javed K, Ryvlin J, Gelfand Y, Murthy S, Yassari R. Are there racial or socioeconomic disparities in ambulatory outcome or survival after oncologic spine surgery for metastatic cancer? Results from a medically underserved center. Clin Orthop Relat Res. 2023;481(2):301\u2013307."},{"key":"b9","series-title":"Cancer Epidemiol","first-page":"102073","article-title":"Insurance status as a mediator of clinical presentation, type of intervention, and short-term outcomes for patients with metastatic spine disease","volume":"76","author":"Price MJ","year":"2022","unstructured":"Price MJ, De la Garza Ramos R, Dalton T,  Insurance status as a mediator of clinical presentation, type of intervention, and short-term outcomes for patients with metastatic spine disease. Cancer Epidemiol. 2022;76:102073."},{"issue":"2","key":"b10","series-title":"Spine J","first-page":"244","article-title":"Disparities in reportable quality metrics by insurance status in the primary spine neoplasm population","volume":"17","author":"Mehdi SK","year":"2017","unstructured":"Mehdi SK, Tanenbaum JE, Alentado VJ,  Disparities in reportable quality metrics by insurance status in the primary spine neoplasm population. Spine J. 2017;17(2):244\u2013251."},{"issue":"8","key":"b11","series-title":"Asian Pac J Cancer Prev","first-page":"3569","article-title":"Importance of social support in cancer patients","volume":"13","author":"Usta YY","year":"2012","unstructured":"Usta YY. Importance of social support in cancer patients. Asian Pac J Cancer Prev. 2012;13(8):3569\u20133572."},{"issue":"11","key":"b12","series-title":"JAMA Oncol","first-page":"1582","article-title":"Out-of-pocket costs, financial distress, and underinsurance in cancer care","volume":"3","author":"Chino F","year":"2017","unstructured":"Chino F, Peppercorn JM, Rushing C,  Out-of-pocket costs, financial distress, and underinsurance in cancer care. JAMA Oncol. 2017;3(11):1582\u20131584."},{"key":"b13","series-title":"World Neurosurg","first-page":"e198","article-title":"The National Inpatient Sample: a primer for neurosurgical big data research and systematic review","volume":"162","author":"Tang OY","year":"2022","unstructured":"Tang OY, Pugacheva A, Bajaj AI, Rivera Perla KM, Weil RJ, Toms SA. The National Inpatient Sample: a primer for neurosurgical big data research and systematic review. World Neurosurg. 2022;162:e198\u2013e217."},{"key":"b14","series-title":"Agency for Healthcare Research and Quality","article-title":"Healthcare Cost and Utilization Project","author":"Overview of the National (Nationwide) Inpatient Sample (NIS)","unstructured":"Overview of the National (Nationwide) Inpatient Sample (NIS). Healthcare Cost and Utilization Project; Agency for Healthcare Research and Quality. Accessed June 1, 2024. https:\/\/www.hcup-us.ahrq.gov\/nisoverview.jsp"},{"issue":"2","key":"b15","series-title":"J Neurosurg Spine","first-page":"241","article-title":"Hospital Frailty Risk Score and healthcare resource utilization after surgery for metastatic spinal column tumors","volume":"37","author":"Elsamadicy AA","year":"2022","unstructured":"Elsamadicy AA, Koo AB, Reeves BC,  Hospital Frailty Risk Score and healthcare resource utilization after surgery for metastatic spinal column tumors. J Neurosurg Spine. 2022;37(2):241\u2013251."},{"issue":"2","key":"b16","series-title":"JAMA Surg","first-page":"120","article-title":"Effect of hospital safety-net burden on cost and outcomes after surgery","volume":"151","author":"Hoehn RS","year":"2016","unstructured":"Hoehn RS, Wima K, Vestal MA,  Effect of hospital safety-net burden on cost and outcomes after surgery. JAMA Surg. 2016;151(2):120\u2013128."},{"issue":"1","key":"b17","series-title":"Neurooncol Adv","first-page":"vdaa167","article-title":"The impact of hospital safety-net status on inpatient outcomes for brain tumor craniotomy: a 10-year nationwide analysis","volume":"3","author":"Tang OY","year":"2020","unstructured":"Tang OY, Rivera Perla KM, Lim RK, Weil RJ, Toms SA. The impact of hospital safety-net status on inpatient outcomes for brain tumor craniotomy: a 10-year nationwide analysis. Neurooncol Adv. 2020;3(1):vdaa167."},{"key":"b18","series-title":"Stroke Res Treat","first-page":"5546766","article-title":"Developing a predictive tool for hospital discharge disposition of patients poststroke with 30-day readmission validation","volume":"2021","author":"Cho J","year":"2021","unstructured":"Cho J, Place K, Salstrand R,  Developing a predictive tool for hospital discharge disposition of patients poststroke with 30-day readmission validation. Stroke Res Treat. 2021;2021:5546766."},{"issue":"51","key":"b19","series-title":"Medicine (Baltimore)","first-page":"e28171","article-title":"Impact of early mobilization on discharge disposition and functional status in patients with subarachnoid hemorrhage: a retrospective cohort study","volume":"100","author":"Okamura M","year":"2021","unstructured":"Okamura M, Konishi M, Sagara A, Shimizu Y, Nakamura T. Impact of early mobilization on discharge disposition and functional status in patients with subarachnoid hemorrhage: a retrospective cohort study. Medicine (Baltimore). 2021;100(51):e28171."},{"issue":"3","key":"b20","series-title":"J Neurosurg","first-page":"687","article-title":"Volume-outcome relationship in neurotrauma care","volume":"118","author":"Clement RC","year":"2013","unstructured":"Clement RC, Carr BG, Kallan MJ, Wolff C, Reilly PM, Malhotra NR. Volume-outcome relationship in neurotrauma care. J Neurosurg. 2013;118(3):687\u2013693."},{"issue":"2","key":"b21","series-title":"Neurosurgery","first-page":"312","article-title":"Association of patient frailty with vestibular schwannoma resection outcomes and machine learning development of a vestibular schwannoma risk stratification score","volume":"91","author":"Tang OY","year":"2022","unstructured":"Tang OY, Bajaj AI, Zhao K,  Association of patient frailty with vestibular schwannoma resection outcomes and machine learning development of a vestibular schwannoma risk stratification score. Neurosurgery. 2022;91(2):312\u2013321."},{"issue":"2","key":"b22","series-title":"J Neurosurg","first-page":"552","article-title":"Predicting mortality in traumatic intracranial hemorrhage","volume":"132","author":"Powers AY","year":"2019","unstructured":"Powers AY, Pinto MB, Tang OY, Chen JS, Doberstein C, Asaad WF. Predicting mortality in traumatic intracranial hemorrhage. J Neurosurg. 2019;132(2):552\u2013559."},{"issue":"4","key":"b23","series-title":"Neurosurgery","first-page":"E500","article-title":"Machine learning with feature domains elucidates candidate drivers of hospital readmission following spine surgery in a large single-center patient cohort","volume":"87","author":"Martini ML","year":"2020","unstructured":"Martini ML, Neifert SN, Oermann EK,  Machine learning with feature domains elucidates candidate drivers of hospital readmission following spine surgery in a large single-center patient cohort. Neurosurgery. 2020;87(4):E500\u2013E510."},{"issue":"2","key":"b24","series-title":"Am J Prev Med","first-page":"129","article-title":"County health rankings: relationships between determinant factors and health outcomes","volume":"50","author":"Hood CM","year":"2016","unstructured":"Hood CM, Gennuso KP, Swain GR, Catlin BB. County health rankings: relationships between determinant factors and health outcomes. Am J Prev Med. 2016;50(2):129\u2013135."},{"issue":"2","key":"b25","series-title":"Health Serv Res","first-page":"677","article-title":"Surgery wait times and specialty services for insured and uninsured breast cancer patients: does hospital safety net status matter?","volume":"47","author":"Bradley CJ","year":"2012","unstructured":"Bradley CJ, Dahman B, Shickle LM, Lee W. Surgery wait times and specialty services for insured and uninsured breast cancer patients: does hospital safety net status matter? Health Serv Res. 2012;47(2):677\u2013697."},{"issue":"3","key":"b26","series-title":"Neurosurgery","first-page":"427","article-title":"Racial, ethnic, and socioeconomic disparities in patient outcomes after craniotomy for tumor in adult patients in the United States, 1988-2004","volume":"66","author":"Curry WT Jr","year":"2010","unstructured":"Curry WT Jr, Carter BS, Barker FG II. Racial, ethnic, and socioeconomic disparities in patient outcomes after craniotomy for tumor in adult patients in the United States, 1988-2004. Neurosurgery. 2010;66(3):427\u2013438."},{"issue":"6","key":"b27","series-title":"Neurosurg Focus","first-page":"E16","article-title":"Disparities in health care determine prognosis in newly diagnosed glioblastoma","volume":"44","author":"Chandra A","year":"2018","unstructured":"Chandra A, Rick JW, Dalle Ore C,  Disparities in health care determine prognosis in newly diagnosed glioblastoma. Neurosurg Focus. 2018;44(6):E16."},{"issue":"19","key":"b28","series-title":"Cancer","first-page":"3390","article-title":"Glioma incidence and survival variations by county-level socioeconomic measures","volume":"125","author":"Cote DJ","year":"2019","unstructured":"Cote DJ, Ostrom QT, Gittleman H,  Glioma incidence and survival variations by county-level socioeconomic measures. Cancer. 2019;125(19):3390\u20133400."},{"issue":"11","key":"b29","series-title":"Arch Surg","first-page":"1017","article-title":"Postoperative mortality after surgery for brain tumors by patient insurance status in the United States","volume":"147","author":"Momin EN","year":"2012","unstructured":"Momin EN, Adams H, Shinohara RT, Frangakis C, Brem H, Qui\u00f1ones-Hinojosa A. Postoperative mortality after surgery for brain tumors by patient insurance status in the United States. Arch Surg. 2012;147(11):1017\u20131024."},{"issue":"16","key":"b30","series-title":"JAMA","first-page":"1973","article-title":"Disparities in the utilization of high-volume hospitals for complex surgery","volume":"296","author":"Liu JH","year":"2006","unstructured":"Liu JH, Zingmond DS, McGory ML,  Disparities in the utilization of high-volume hospitals for complex surgery. JAMA. 2006;296(16):1973\u20131980."},{"issue":"3","key":"b31","series-title":"Arch Surg","first-page":"247","article-title":"Disparities in access to neuro-oncologic care in the United States","volume":"145","author":"Mukherjee D","year":"2010","unstructured":"Mukherjee D, Zaidi HA, Kosztowski T,  Disparities in access to neuro-oncologic care in the United States. Arch Surg. 2010;145(3):247\u2013253."},{"issue":"3","key":"b32","series-title":"JAMA Surg","first-page":"274","article-title":"Racial disparities in the use of surgical procedures in the US","volume":"156","author":"Best MJ","year":"2021","unstructured":"Best MJ, McFarland EG, Thakkar SC, Srikumaran U. Racial disparities in the use of surgical procedures in the US. JAMA Surg. 2021;156(3):274\u2013281."},{"issue":"3","key":"b33","series-title":"Ann Surg","first-page":"459","article-title":"Disparities in rates of surgical intervention among racial and ethnic minorities in Medicare accountable care organizations","volume":"269","author":"Schoenfeld AJ","year":"2019","unstructured":"Schoenfeld AJ, Sturgeon DJ, Dimick JB,  Disparities in rates of surgical intervention among racial and ethnic minorities in Medicare accountable care organizations. Ann Surg. 2019;269(3):459\u2013464."},{"issue":"3","key":"b34","series-title":"J Spine Surg","first-page":"277","article-title":"Influence of psychosocial and sociodemographic factors in the surgical management of traumatic cervicothoracic spinal cord injury at level I and II trauma centers in the United States","volume":"7","author":"Hagan MJ","year":"2021","unstructured":"Hagan MJ, Pertsch NJ, Leary OP,  Influence of psychosocial and sociodemographic factors in the surgical management of traumatic cervicothoracic spinal cord injury at level I and II trauma centers in the United States. J Spine Surg. 2021;7(3):277\u2013288."},{"key":"b35","series-title":"J Clin Neurosci","first-page":"48","article-title":"Outcomes after clipping and endovascular coiling for aneurysmal subarachnoid hemorrhage among dual-eligible beneficiaries","volume":"90","author":"Corcoran Ruiz KM","year":"2021","unstructured":"Corcoran Ruiz KM, Rivera Perla KM, Tang OY, Toms SA, Weil RJ. Outcomes after clipping and endovascular coiling for aneurysmal subarachnoid hemorrhage among dual-eligible beneficiaries. J Clin Neurosci. 2021;90:48\u201355."},{"issue":"2","key":"b36","series-title":"J Neurooncol","first-page":"387","article-title":"Brain tumor craniotomy outcomes for dual-eligible medicare and medicaid patients: a 10-year nationwide analysis","volume":"156","author":"Tang OY","year":"2022","unstructured":"Tang OY, Clarke RA, Rivera Perla KM, Corcoran Ruiz KM, Toms SA, Weil RJ. Brain tumor craniotomy outcomes for dual-eligible medicare and medicaid patients: a 10-year nationwide analysis. J Neurooncol. 2022;156(2):387\u2013398."},{"issue":"11","key":"b37","series-title":"Health Aff (Millwood)","first-page":"2025","article-title":"Identifying hospitals that may be at most financial risk from Medicaid disproportionate-share hospital payment cuts","volume":"33","author":"Cole ES","year":"2014","unstructured":"Cole ES, Walker D, Mora A, Diana ML. Identifying hospitals that may be at most financial risk from Medicaid disproportionate-share hospital payment cuts. Health Aff (Millwood). 2014;33(11):2025\u20132033."},{"issue":"8","key":"b38","series-title":"Am J Public Health","first-page":"1416","article-title":"Effect of the Affordable Care Act on racial and ethnic disparities in health insurance coverage","volume":"106","author":"Buchmueller TC","year":"2016","unstructured":"Buchmueller TC, Levinson ZM, Levy HG, Wolfe BL. Effect of the Affordable Care Act on racial and ethnic disparities in health insurance coverage. Am J Public Health. 2016;106(8):1416\u20131421."},{"key":"b39","series-title":"Kaiser Family Foundation","article-title":"Effects of the ACA Medicaid expansion on racial disparities in health and health care","author":"Guth M","year":"2020","unstructured":"Guth M, Artiga S, Pham O. Effects of the ACA Medicaid expansion on racial disparities in health and health care. Kaiser Family Foundation. September 30, 2020.Accessed June 1, 2024. https:\/\/www.kff.org\/medicaid\/issue-brief\/effects-of-the-aca-medicaid-expansion-on-racial-disparities-in-health-and-health-care\/"},{"issue":"1","key":"b40","series-title":"Neurosurgery","first-page":"123","article-title":"Is the Centers for Medicare and Medicaid Services hierarchical condition category risk adjustment model satisfactory for quantifying risk after spine surgery?","volume":"91","author":"Chan AK","year":"2022","unstructured":"Chan AK, Shahrestani S, Ballatori AM,  Is the Centers for Medicare and Medicaid Services hierarchical condition category risk adjustment model satisfactory for quantifying risk after spine surgery? Neurosurgery. 2022;91(1):123\u2013131."},{"issue":"3","key":"b41","series-title":"J Neurooncol","first-page":"349","article-title":"Predicting access to postoperative treatment after glioblastoma resection: an analysis of neighborhood-level disadvantage using the Area Deprivation Index (ADI)","volume":"158","author":"Rivera Perla KM","year":"2022","unstructured":"Rivera Perla KM, Tang OY, Durfey SNM,  Predicting access to postoperative treatment after glioblastoma resection: an analysis of neighborhood-level disadvantage using the Area Deprivation Index (ADI). J Neurooncol. 2022;158(3):349\u2013357."},{"issue":"3","key":"b42","series-title":"Health Aff (Millwood)","first-page":"375","article-title":"Three-year impact of stratification in the Medicare Hospital Readmissions Reduction Program","volume":"41","author":"Shashikumar SA","year":"2022","unstructured":"Shashikumar SA, Waken RJ, Aggarwal R, Wadhera RK, Joynt Maddox KE. Three-year impact of stratification in the Medicare Hospital Readmissions Reduction Program. Health Aff (Millwood). 2022;41(3):375\u2013382."},{"issue":"22","key":"b43","series-title":"Circulation","first-page":"e841","article-title":"Addressing social determinants of health in the care of patients with heart failure: a scientific statement from the American Heart Association","volume":"141","author":"White-Williams C","year":"2020","unstructured":"White-Williams C, Rossi LP, Bittner VA,  Addressing social determinants of health in the care of patients with heart failure: a scientific statement from the American Heart Association. Circulation. 2020;141(22):e841\u2013e863."},{"issue":"6","key":"b44","series-title":"J Neurosurg Spine","first-page":"984","article-title":"The Nationwide Inpatient Sample database does not accurately reflect surgical indications for fusion","volume":"21","author":"Gologorsky Y","year":"2014","unstructured":"Gologorsky Y, Knightly JJ, Chi JH, Groff MW. The Nationwide Inpatient Sample database does not accurately reflect surgical indications for fusion. J Neurosurg Spine. 2014;21(6):984\u2013993."},{"issue":"5","key":"b45","series-title":"Neurosurgery","first-page":"808","article-title":"The impact of frailty on traumatic brain injury outcomes: an analysis of 691 821 nationwide cases","volume":"91","author":"Tang OY","year":"2022","unstructured":"Tang OY, Shao B, Kimata AR, Sastry RA, Wu J, Asaad WF. The impact of frailty on traumatic brain injury outcomes: an analysis of 691 821 nationwide cases. Neurosurgery. 2022;91(5):808\u2013820."}],"container-title":["Journal of Neurosurgery: Spine"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-spine\/41\/6\/article-p677.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-spine\/41\/6\/article-p677.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-spine\/41\/6\/article-p677.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,12,6]],"date-time":"2024-12-06T13:21:06Z","timestamp":1733491266000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-spine\/41\/6\/article-p677.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,12,1]]},"references-count":45,"journal-issue":{"issue":"6"},"URL":"https:\/\/doi.org\/10.3171\/2024.5.spine231081","relation":{},"ISSN":["1547-5654"],"issn-type":[{"value":"1547-5654","type":"print"}],"subject":[],"published":{"date-parts":[[2024,12,1]]}}}