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Acutely injured patients with trauma in Massachusetts: Differences in care and mortality, by insurance status

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  • Haas, J.S.
  • Goldman, L.

Abstract

Objectives. This study was designed to determine whether resource use and mortality differed by insurance status for patients with acute trauma. Methods. All adults emergently hospitalized in Massachusetts during 1990 with acute trauma (n = 15 008) were examined. Results. After adjustment for confounders, uninsured patients were as likely to receive care in an intensive care unit as were patients with private insurance (odds ratio [OR] = 0.97, 95% confidence interval [CI] = 0.85, 1.11) but were less likely to undergo an operative procedure (OR = 0.68, 95% CI = 0.63, 0.74) or physical therapy (OR = 0.61, 95% CI = 0.57, 0.67) and were more likely to die in a hospital (OR = 2.15, 95% CI = 1.44, 3.19). Compared with patients with private insurance, those with Medicaid were less likely to receive an operative procedure (0.85, 0.75-0.97), were equally likely to receive care in an intensive care unit (OR = 1.05, 95% CI = 0.86, 1.30) or physical therapy (OR = 0.90, 95% CI = 0.79, 1.02), and were no more likely to die (OR = 1.28, 95% CI = 0.69, 2.39). Conclusions. These results suggest that the uninsured receive less trauma-related care and have a higher mortality rate. The excess mortality in uninsured patients may be avoided if their resource use is increased to that of insured patients.

Suggested Citation

  • Haas, J.S. & Goldman, L., 1994. "Acutely injured patients with trauma in Massachusetts: Differences in care and mortality, by insurance status," American Journal of Public Health, American Public Health Association, vol. 84(10), pages 1605-1608.
    • Handle: RePEc:aph:ajpbhl:1994:84:10:1605-1608_1
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    Cited by:

    1. Joseph J. Doyle Jr., 2005. "Health Insurance, Treatment and Outcomes: Using Auto Accidents as Health Shocks," NBER Working Papers 11099, National Bureau of Economic Research, Inc.
    2. Kon, Alexander A. & Pretzlaff, Robert K. & Marcin, James P., 2004. "The association of race and ethnicity with rates of drug and alcohol testing among US trauma patients," Health Policy, Elsevier, vol. 69(2), pages 159-167, August.
    3. John Karl Scholz & Ananth Seshadri, 2012. "The Interplay of Wealth, Retirement Decisions, Policy and Economic Shocks," Working Papers wp271, University of Michigan, Michigan Retirement Research Center.
    4. John Karl Scholz & Ananth Seshadri, 2013. "Health Insurance and Retirement Decisions," Working Papers wp292, University of Michigan, Michigan Retirement Research Center.
    5. Lara Bryant & Sharmila Vishwasrao, 2006. "Physician Quality and Health Care for the Poor and Uninsured," Working Papers 06001, Department of Economics, College of Business, Florida Atlantic University.
    6. Gaon-Sorae Wang & Kyoung-Min You & You-Hwan Jo & Hui-Jai Lee & Jong-Hwan Shin & Yoon-Sun Jung & Ji-Eun Hwang, 2021. "Association of Health Insurance Status with Outcomes of Sepsis in Adult Patients: A Retrospective Cohort Study," IJERPH, MDPI, vol. 18(11), pages 1-11, May.

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