O1077: Insurance Status and Outcomes of Patients with Slipped Capital Femoral Epiphysis (SCFE)

Background: Previous studies have shown the delay in diagnosis of slipped capital femoral epiphysis (SCFE) is associated with increased slip severity and worse clinical outcomes. Furthermore, lower socioeconomic status (SES) is associated with a higher incidence of SCFE and delayed diagnosis. The relationship between insurance status as a marker for SES and clinical outcomes in patients with SCFE has yet to be established. The purpose of this study is to determine whether insurance status affects SCFE treatment and recovery.

Methods: Charts and radiographs were retrospectively reviewed for all patients who presented with SCFE between January 2003 and August 2017 at a single tertiary pediatric hospital. Data were collected on demographics, treatment, and outcomes. Insurance type was classified as public or private. Patient characteristics and the rate of complications and second SCFE were compared between insurance types using t-tests for continuous variables and Fisher’s exact test for categorical variables.

Results: The groups were similar at presentation except for larger Southwick angle and a trend towards more unstable slips in the patients with public insurance (Table 1). The groups presented at a similar time (after a similar duration of pain and with a similar percentage who had previously consulted with another medical provider). No significant differences in outcomes were observed between groups (Table 2).

Conclusion: Patients with government insurance presented with worse SCFE as measured by Southwick angle and trended towards having more unstable slips at diagnosis. While they did not have an overall worse outcome, patients with government insurance did have worse SCFEs at initial diagnosis.