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An Evaluation of Trauma Outcomes Related to Insurance Status in Patients Requiring Prehospital Helicopter Transport

Published online by Cambridge University Press:  20 November 2014

Lori A. Gurien ,
David J. Chesire ,
Stephanie L. Koonce  and
J. Bracken Burns Jr.
Lori A. Gurien*
Affiliation:
University of Florida, College of Medicine - Jacksonville, Jacksonville, FloridaUSA
David J. Chesire
Affiliation:
University of Florida, College of Medicine - Jacksonville, Jacksonville, FloridaUSA
Stephanie L. Koonce
Affiliation:
Mayo Clinic Florida, Jacksonville, FloridaUSA
J. Bracken Burns Jr.
Affiliation:
University of Florida, College of Medicine - Jacksonville, Jacksonville, FloridaUSA
*
Correspondence: Lori A. Gurien, MD, MPH 111 E. Markham Street, #B506 Little Rock, Arkansas 72201 USA E-mail [email protected]
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Abstract

Introduction

Disparities in access to medical care and outcomes of medical treatment related to insurance status are documented. However, little attention has been given to the effect of health care funding status on outcomes in trauma patients.

Hypothesis/Problem

This study evaluated if adult trauma patients who arrived by air transport to a trauma center had different clinical outcomes based on their health insurance status.

Methods

A retrospective analysis was performed of all adult trauma patients arriving by prehospital flight services to a Level I Trauma Center over a 5-year period. Patients were classified as unfunded or funded based on health insurance status. Injury severity scores (ISS) were compared, while the end points evaluated in the study included duration of stay in the intensive care unit (ICU), duration of hospitalization, and mortality.

Results

A total of 1,877 adult patients met inclusion criteria for the study, with 14% (n = 259) classified as unfunded and 86% (n = 1,618) classified as funded. Unfunded patients compared to funded patients had a significantly lower average ISS (12.82 vs 15.56; P < .001) but a significantly higher mortality rate (16.6% vs 10.7%; P < .01) and a 1.54 relative risk of death (95% CI, 1.136-2.098). Neither mean ICU stay (3.44 days vs 4.98 days; P = .264) nor duration of hospitalization (11.18 days vs 13.34 days; P = .382) was significantly different when controlling for ISS.

Conclusion

Unfunded health insurance status is associated with worse outcomes following less significant injury. Further investigation of baseline health disparities for identification and early intervention may improve outcomes. Additionally, these findings may have implications for the health systems of other countries that lack universal health care coverage.

GurienLA, ChesireDJ, KoonceSL, BurnsJBJr. An Evaluation of Trauma Outcomes Related to Insurance Status in Patients Requiring Prehospital Helicopter Transport. Prehosp Disaster Med. 2014;29(6):1-4.

Keywords

helicopterinsurancemortalityoutcomestrauma
Type
Original Research
Information
Prehospital and Disaster Medicine , Volume 30 , Issue 1 , February 2015 , pp. 62 - 65
Copyright
Copyright © World Association for Disaster and Emergency Medicine 2014 

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Footnotes

Conflicts of interest: none

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