TY - JOUR PY - 2012// TI - Does payer status matter in predicting penetrating trauma outcomes? JO - Surgery A1 - Taghavi, Sharven A1 - Jayarajan, Senthil N. A1 - Duran, Jason M. A1 - Gaughan, John P. A1 - Pathak, Abhijit A1 - Santora, Thomas A. A1 - Willis, Alliric I. A1 - Goldberg, Amy J. SP - 227 EP - 231 VL - 152 IS - 2 N2 - BACKGROUND: Few data exist regarding payer status as a predictor of outcomes in penetrating trauma. This study determined whether insurance status impacts in-hospital complications and mortality in gunshot and stab wound patients at our inner-city, level I trauma center. METHODS: Penetrating trauma admissions from 2005 to 2009 were reviewed for patient demographics, insurance, Injury Severity Score, complications, duration of stay, and mortality. RESULTS: A total of 1,347 penetrating trauma patients were admitted with 652 (48.4%) uninsured. Although uninsured patients were more likely to be male (93.3% vs 89.8%, P = .030), there was no difference in age, ISS, or number of radiologic, operative, or interventional procedures. Uninsured patients had lesser intensive care unit (4.4 vs 3.3 days; P = .049) and total hospital length of stay (10.2 vs 8.3; P = .049). No uninsured patients were placed into a rehabilitation facility at the time of discharge (0.0% vs 1.6%, P < .001). There was no difference in frequency of pulmonary complications, thromboembolic complications, sepsis, urinary tract infection, or wound infections. On multivariate analysis, being uninsured was not an independent predictor of in-hospital complications (1.010, 95% confidence interval 0.703-1.450, P = .959) or mortality (odds ratio 0.905, 95% confidence interval 0.523-1.566, P = .722). CONCLUSION: This is the first study to show that penetrating trauma patients who are uninsured have lesser duration of stay and decreased placement into a rehabilitation facility. Being uninsured added no additional risk of in-hospital complications or mortality.
Language: en
LA - en SN - 0039-6060 UR - http://dx.doi.org/10.1016/j.surg.2012.05.039 ID - ref1 ER -