Closing the Loop: How Insurance and Social Determinants Shape Post-Surgical Outcomes and Healthcare Costs

Post-operative readmissions following emergency general surgery (EGS) are costly, frequent, and often preventable. While insurance coverage and social determinants of health (SDOH) are known to shape surgical outcomes, few studies directly compare Medicaid and commercially insured patients while accounting for socioeconomic barriers. A retrospective database of emergency department (ED) admissions at Beth Israel Deaconess Medical Center from 2008 to 2022 was queried to identify patients who underwent EGS procedures using ICD-9 & 10 codes. The following parameters were compared: Demographic (age, race, language), Clinical(length of stay, readmission, Post-Operative complications), and Insurance data were extracted. Statistical analysis was performed using the Chi-square test, sample t-tests with Satterthwaite correction for unequal variances A total of 6,816 patients undergoing EGS were identified, including 1492 (21.9%) Medicaid and 5,322 (78.1%) privately insured patients. Medicaid patients had a significantly longer mean hospital stay (218.7 ± 361.7 hours) compared to privately insured patients (158.2 ± 247.1 hours), representing an approximate 2.5-day increase in length of stay (t=6.07, p