Not Just an Urban Phenomenon: Uninsured Rural Trauma Patients at Increased Risk for Mortality
| Autor: | Junlin Liao, Karisa K. Harland, Azeemuddin Ahmed, Dionne A. Skeete, Bryce Hoffman, Kent Choi, Gerene M. Denning |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2015 |
| Předmět: |
Adult
Male Rural Population medicine.medical_specialty Poison control lcsh:Medicine Trauma Centers Risk Factors Epidemiology Odds Ratio Medicine Humans Registries Original Research Retrospective Studies Medically Uninsured Insurance Health business.industry Medicaid Major trauma Trauma center lcsh:R lcsh:Medical emergencies. Critical care. Intensive care. First aid Retrospective cohort study General Medicine Emergency department Odds ratio lcsh:RC86-88.9 insurance status Middle Aged medicine.disease mortality Health Outcomes United States trauma Logistic Models Emergency medicine Emergency Medicine Wounds and Injuries epidemiology Female business |
| Zdroj: | Western Journal of Emergency Medicine Ahmed, Azeemuddin; Harland, Karisa K.; Hoffman, Bryce; Liao, Junlin; Choi, Kent; Skeete, Dionne; et al.(2015). Not Just an Urban Phenomenon: Uninsured Rural Trauma Patients at Increased Risk for Mortality. Western Journal of Emergency Medicine, 16(5). doi: 10.5811/westjem.2015.7.27351. Retrieved from: http://www.escholarship.org/uc/item/9cr6q890 Western Journal of Emergency Medicine, Vol 16, Iss 5, Pp 632-641 (2015) |
| ISSN: | 1936-9018 1936-900X |
| Popis: | INTRODUCTION: National studies of largely urban populations showed increased risk of traumatic death among uninsured patients, as compared to those insured. No similar studies have been done for major trauma centers serving rural states. METHODS: We performed retrospective analyses using trauma registry records from adult, non-burn patients admitted to a single American College of Surgeons-certified Level 1 trauma center in a rural state (2003-2010, n=13,680) and National Trauma Data Bank (NTDB) registry records (2002-2008, n=380,182). Risk of traumatic death was estimated using multivariable logistic regression analysis. RESULTS: We found that 9% of trauma center patients and 27% of NTDB patients were uninsured. Overall mortality was similar for both (~4.5%). After controlling for covariates, uninsured trauma center patients were almost five times more likely to die and uninsured NTDB patients were 75% more likely to die than commercially insured patients. The risk of death among Medicaid patients was not significantly different from the commercially insured for either dataset. CONCLUSION: Our results suggest that even with an inclusive statewide trauma system and an emergency department that does not triage by payer status, uninsured patients presenting to the trauma center were at increased risk of traumatic death relative to patients with commercial insurance. Language: en |
| Databáze: | OpenAIRE |
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