Person: Curiel, Daniel
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Curiel
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Daniel
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Curiel, Daniel
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Publication Immediate Breast Reconstruction among Patients with Medicare and Private Insurance: A Matched Cohort Analysis(Wolters Kluwer Health, 2018) Kamali-Sadeghian, Parisa; Ricci, Joseph A.; Curiel, Daniel; Cohen, Justin B.; Chattha, Anmol; Rakhorst, Hinne A.; Lee, Bernard; Lin, SamuelBackground: By eliminating economic hurdles, the Women’s Health and Cancer Rights Act of 1998 represented a paradigm shift in the availability of breast reconstruction. Yet, studies report disparities among Medicare-insured women. These studies do not account for the inherent differences in age and comorbidities between a younger privately insured and an older Medicare population. We examined immediate breast reconstruction (IBR) utilization between a matched pre- and post-Medicare population. Methods: Using the Nationwide Inpatient Sample database (1992–2013), breast cancer patients undergoing IBR were identified. To minimize confounding medical variables, 64-year-old privately insured women were compared with 66-year-old Medicare-insured women. Demographic data, IBR rates, and complication rates were compared. Trend over time was plotted for both cohorts. Result: A total of 21,402 64-year-old women and 25,568 66-year-old women were included. Both groups were well matched in terms of demographic type of reconstruction and complication rates. 72.3% of 64-year-old and 71.2 of % 66-year-old women opted for mastectomy. Of these, 25.5% (n = 3,941) of 64-year-old privately insured and 17.7% (n = 3,213) of 66-year-old Medicare-insured women underwent IBR (P < 0.01). During the study period, IBR rates increased significantly in both cohorts in a similar cohort. Conclusion: This study demonstrates significant increasing IBR rates in both cohorts. Moreover, after an initial slower upward trend, after a decade, IBR in 66-year-old Medicare-insured women approached similar rates of breast reconstruction among those with private insurance. Trends in unilateral versus bilateral mastectomy are also seen.Publication Abstract: Institutional Diversity in Academic Plastic Surgery: A Collaborative Solution to Resource Limitations(Wolters Kluwer Health, 2017) Chi, David; Curiel, Daniel; Bucknor, Alexandra; Peymani, Abbas; Chattha, Anmol S.; Chen, Austin D.; Bletsis, Patrick P.; Lin, Samuel