Medical Student Steven Medvedovsky's Research Study Published in JAMA Surgery

Jan 1, 2025

The SUNY Downstate Department of Surgery is excited to announce that the original investigation "Facility Medicaid Payer Burden and Nonelective Admission for Chronic Limb-Threatening Ischemia", authored by third-year medical student and iNSPIRe member Steven Medvedovsky, under the mentorship of Professor and Chair of Surgery Panos Kougias, MD, MSc, FACS, and Assistant Professor and Director of Clinical and Health Services Research Sherene Sharath, PhD, MPH, has been accepted for publication in JAMA Surgery. 

As of 2024, JAMA Surgery holds an impact factor of 16.9 with an acceptance rate of just 6% for original investigations, making it the highest-ranking surgery journal in the world. 

Their study investigated the association between hospital resource limitations, measured by the proportion of hospital stays paid for by Medicaid, and the severity and complexity of patients presenting with chronic limb threatening ischemia (CLTI). After adjusting for patient and facility-level factors, the study found that the odds of non-elective CLTI admissions increased with rising facility Medicaid burden. These findings highlight a critical mismatch in the care of CLTI: as hospital resources become increasingly constrained, the odds of managing patients with more severe disease presentations rise. 

We are immensely proud of Steven, Dr. Sharath, and Dr. Kougias for their exceptional dedication to advancing health equity through research in surgery. This study lays the foundation for strategies to optimize resource allocation, ensuring vulnerable facilities are better equipped to care for the patients who need it most.