For patients who have suffered this type of stroke, surgical intervention can spell the difference between recovery or long-term disability and death, yet patients on Medicare are less likely than those with private insurance to be referred for surgical treatment, according to findings published in the journal PLOS ONE. This may represent a conscious or unconscious bias against Medicare patients, who are typically older and have preexisting disabilities or chronic illnesses, said Azra Bihorac, M.D., senior author of the study and an associate professor of anesthesiology, medicine and surgery at the UF College of Medicine.
"Not every hospital has skilled neurosurgeons who specialize in subarachnoid hemorrhage," Bihorac said. "If these hospitals don't have the necessary expertise, then they may actually overestimate the risk of a bad prognosis. They may assume that the patient won't do well anyway, so they won't proceed with surgery."