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dc.contributor.authorOsler, Turner
dc.contributor.authorGlance, Laurent G.
dc.contributor.authorLi, Wenjun
dc.contributor.authorBuzas, Jeffery S.
dc.contributor.authorWetzel, Megan L.
dc.contributor.authorHosmer, David W.
dc.date2022-08-11T08:08:34.000
dc.date.accessioned2022-08-23T15:59:39Z
dc.date.available2022-08-23T15:59:39Z
dc.date.issued2015-05-01
dc.date.submitted2016-06-15
dc.identifier.citationJ Trauma Acute Care Surg. 2015 May;78(5):1026-33. doi: 10.1097/TA.0000000000000593. <a href="http://dx.doi.org/10.1097/TA.0000000000000593">Link to article on publisher's site</a>
dc.identifier.issn2163-0755 (Linking)
dc.identifier.doi10.1097/TA.0000000000000593
dc.identifier.pmid25909426
dc.identifier.urihttp://hdl.handle.net/20.500.14038/30720
dc.description.abstractBACKGROUND: Previous studies have reported that black race and lack of health insurance coverage are associated with increased mortality following traumatic injury. However, the association of race and insurance status with trauma outcomes has not been examined using contemporary, national, population-based data. METHODS: We used data from the National Inpatient Sample on 215,615 patients admitted to 1 of 836 hospitals following traumatic injury in 2010. We examined the effects of race and insurance coverage on mortality using two logistic regression models, one for patients younger than 65 years and the other for older patients. RESULTS: Unadjusted mortality was low for white (2.71%), black (2.54%), and Hispanic (2.03%) patients. We found no difference in adjusted survival for nonelderly black patients compared with white patients (adjusted odds ratio [AOR], 1.04; 95% confidence interval [CI], 0.90-1.19; p = 0.550). Elderly black patients had a 25% lower odds of mortality compared with elderly white patients (AOR, 0.75; 95% CI, 0.63-0.90; p = 0.002). After accounting for survivor bias, insurance coverage was not associated with improved survival in younger patients (AOR, 0.91; 95% CI, 0.77-1.07; p = 0.233). CONCLUSION: Black race is not associated with higher mortality following injury. Health insurance coverage is associated with lower mortality, but this may be the result of hospitals' inability to quickly obtain insurance coverage for uninsured patients who die early in their hospital stay. Increasing insurance coverage may not improve survival for patients hospitalized following injury. LEVEL OF EVIDENCE: Epidemiologic and prognostic study, level III.
dc.language.isoen_US
dc.relation<a href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&list_uids=25909426&dopt=Abstract">Link to Article in PubMed</a>
dc.relation.urlhttp://www.ncbi.nlm.nih.gov/pmc/articles/PMC4410431/
dc.subjectClinical Epidemiology
dc.subjectEpidemiology
dc.subjectSurgery
dc.subjectTrauma
dc.titleTrauma care does not discriminate: The association of race and health insurance with mortality following traumatic injury
dc.typeJournal Article
dc.source.journaltitleThe journal of trauma and acute care surgery
dc.source.volume78
dc.source.issue5
dc.identifier.legacycoverpagehttps://escholarship.umassmed.edu/faculty_pubs/999
dc.identifier.contextkey8734751
html.description.abstract<p>BACKGROUND: Previous studies have reported that black race and lack of health insurance coverage are associated with increased mortality following traumatic injury. However, the association of race and insurance status with trauma outcomes has not been examined using contemporary, national, population-based data.</p> <p>METHODS: We used data from the National Inpatient Sample on 215,615 patients admitted to 1 of 836 hospitals following traumatic injury in 2010. We examined the effects of race and insurance coverage on mortality using two logistic regression models, one for patients younger than 65 years and the other for older patients.</p> <p>RESULTS: Unadjusted mortality was low for white (2.71%), black (2.54%), and Hispanic (2.03%) patients. We found no difference in adjusted survival for nonelderly black patients compared with white patients (adjusted odds ratio [AOR], 1.04; 95% confidence interval [CI], 0.90-1.19; p = 0.550). Elderly black patients had a 25% lower odds of mortality compared with elderly white patients (AOR, 0.75; 95% CI, 0.63-0.90; p = 0.002). After accounting for survivor bias, insurance coverage was not associated with improved survival in younger patients (AOR, 0.91; 95% CI, 0.77-1.07; p = 0.233).</p> <p>CONCLUSION: Black race is not associated with higher mortality following injury. Health insurance coverage is associated with lower mortality, but this may be the result of hospitals' inability to quickly obtain insurance coverage for uninsured patients who die early in their hospital stay. Increasing insurance coverage may not improve survival for patients hospitalized following injury.</p> <p>LEVEL OF EVIDENCE: Epidemiologic and prognostic study, level III.</p>
dc.identifier.submissionpathfaculty_pubs/999
dc.contributor.departmentPrevention Research Center
dc.contributor.departmentDepartment of Medicine, Division of Preventive and Behavioral Medicine
dc.source.pages1026-33


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