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Association Between Insurance Status and Hospital Length of Stay Following Trauma.

Publication ,  Journal Article
Englum, BR; Hui, X; Zogg, CK; Chaudhary, MA; Villegas, C; Bolorunduro, OB; Stevens, KA; Haut, ER; Cornwell, EE; Efron, DT; Haider, AH
Published in: The American surgeon
March 2016

Previous research has demonstrated that nonclinical factors are associated with differences in clinical care, with uninsured patients receiving decreased resource use. Studies on trauma populations have also shown unclear relationships between insurance status and hospital length of stay (LOS), a commonly used metric for evaluating quality of care. The objective of this study is to define the relationship between insurance status and LOS after trauma using the largest available national trauma dataset and controlling for significant confounders. Data from 2007 to 2010 National Trauma Data Bank were used to compare differences in LOS among three insurance groups: privately insured, publically insured, and uninsured trauma patients. Multivariable regression models adjusted for potential confounding due to baseline differences in injury severity and demographic and clinical factors. A total of 884,493 patients met the inclusion criteria. After adjusting for the influence of covariates, uninsured patients had significantly shorter hospital stays (0.3 days) relative to privately insured patients. Publicly insured patients had longer risk-adjusted LOS (0.9 days). Stratified differences in discharge disposition and injury severity significantly altered the relationship between insurance status and LOS. In conclusion, this study elucidates the association between insurance status and hospital LOS, demonstrating that a patient's ability to pay could alter LOS in acute trauma patients. Additional research is needed to examine causes and outcomes from these differences to increase efficiency in the health care system, decrease costs, and shrink disparities in health outcomes.

Published In

The American surgeon

DOI

EISSN

1555-9823

ISSN

0003-1348

Publication Date

March 2016

Volume

82

Issue

3

Start / End Page

281 / 288

Related Subject Headings

  • Young Adult
  • Wounds and Injuries
  • Surgery
  • Middle Aged
  • Male
  • Length of Stay
  • Insurance Coverage
  • Humans
  • Female
  • Adult
 

Citation

APA
Chicago
ICMJE
MLA
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Englum, B. R., Hui, X., Zogg, C. K., Chaudhary, M. A., Villegas, C., Bolorunduro, O. B., … Haider, A. H. (2016). Association Between Insurance Status and Hospital Length of Stay Following Trauma. The American Surgeon, 82(3), 281–288. https://doi.org/10.1177/000313481608200324
Englum, Brian R., Xuan Hui, Cheryl K. Zogg, Muhammad Ali Chaudhary, Cassandra Villegas, Oluwaseyi B. Bolorunduro, Kent A. Stevens, et al. “Association Between Insurance Status and Hospital Length of Stay Following Trauma.The American Surgeon 82, no. 3 (March 2016): 281–88. https://doi.org/10.1177/000313481608200324.
Englum BR, Hui X, Zogg CK, Chaudhary MA, Villegas C, Bolorunduro OB, et al. Association Between Insurance Status and Hospital Length of Stay Following Trauma. The American surgeon. 2016 Mar;82(3):281–8.
Englum, Brian R., et al. “Association Between Insurance Status and Hospital Length of Stay Following Trauma.The American Surgeon, vol. 82, no. 3, Mar. 2016, pp. 281–88. Epmc, doi:10.1177/000313481608200324.
Englum BR, Hui X, Zogg CK, Chaudhary MA, Villegas C, Bolorunduro OB, Stevens KA, Haut ER, Cornwell EE, Efron DT, Haider AH. Association Between Insurance Status and Hospital Length of Stay Following Trauma. The American surgeon. 2016 Mar;82(3):281–288.

Published In

The American surgeon

DOI

EISSN

1555-9823

ISSN

0003-1348

Publication Date

March 2016

Volume

82

Issue

3

Start / End Page

281 / 288

Related Subject Headings

  • Young Adult
  • Wounds and Injuries
  • Surgery
  • Middle Aged
  • Male
  • Length of Stay
  • Insurance Coverage
  • Humans
  • Female
  • Adult