Impact of Type of Health Insurance on Infection Rates among Young Trauma Patients
| Autor: | William G. Cioffi, Jaswin S. Sawhney, Tareq Kheirbek, Daithi S. Heffernan, Andrew H. Stephen, Stephanie N. Lueckel, Hector Nunez, Charles A. Adams |
|---|---|
| Rok vydání: | 2016 |
| Předmět: |
Adult
Male Microbiology (medical) medicine.medical_specialty Poison control Comorbidity Medicare Occupational safety and health Young Adult 03 medical and health sciences Postoperative Complications 0302 clinical medicine Injury prevention medicine Humans Surgical Wound Infection 030212 general & internal medicine Retrospective Studies Medically Uninsured Insurance Health Medicaid business.industry 030208 emergency & critical care medicine Retrospective cohort study Pneumonia medicine.disease United States Infectious Diseases Blunt trauma Family medicine Wounds and Injuries Female Surgery Medical emergency business Trauma surgery |
| Zdroj: | Surgical Infections. 17:541-546 |
| ISSN: | 1557-8674 1096-2964 |
| DOI: | 10.1089/sur.2015.210 |
| Popis: | Many studies have described the detrimental effect of lack of health insurance on trauma-related outcomes. It is unclear, though, whether these effects are related to pre-injury health status, access to trauma centers, or differences in quality of care after presentation. The aim of this study was to determine if patient and insurance type affect outcomes after trauma surgery.We conducted a retrospective chart review of prospectively collected data at the American College of Surgeons level 1 trauma registry in Rhode Island. All blunt trauma patients aged 18-45 observed from 2004 to 2014 were included. Patients were divided into one of four groups on the basis of their type of insurance: Private/commercial, Medicare, Medicaid, and uninsured. Co-morbidities and infections were recorded. Analysis of variance or the Mann-Whitney U test, as appropriate, was used to analyze the data.A total of 8,018 patients were included. Uninsured patients were more likely to be male and younger, whereas the Medicare patient group had significantly fewer male patients. Rates of co-morbidities were highest in the Medicare group (28.1%) versus the private insurance (16.7%), Medicaid (19.9%), and uninsured (12.9%) groups (p 0.05). However, among patients with any co-morbidity, there was no difference in the average number of co-morbidities between insurance groups. The rate of infection was highest in Medicaid patients (7.7%) versus private (5.6%), Medicare (6.3%), and uninsured (4.3%) patients (p 0.05). Only Medicaid was associated with a significantly greater risk of developing a post-injury infection (odds ratio 1.6; 95% confidence interval 1.1-2.3).The presence of insurance, namely Medicaid, does not equate to diagnosis and management of conditions that affect trauma outcomes. Medicaid is associated with worse pre-trauma health maintenance and a greater risk of infection. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|