The paralyzing effect of insurance status on throughput of acute spinal cord patients - 24/05/19
, Tabitha Garwe, Kiran Venincasa, Tyler Zander, Cullen McCarthy, Morgan Bonds, Zoona Sarwar, Roxie Albrecht, Jason Lees, Aaron Scifres, Alisa CrossAbstract |
Objective |
To determine whether lack of insurance is a predictor of poor outcomes and increased healthcare expenditure for SCI patients.
Methods |
Retrospective cohort study of trauma patients admitted with an acute, severe (AIS ≥ 3) SCI and admission score of ASIA-A to a Level 1 trauma center (2012–2016). Patient characteristics and outcomes (LOS, complications) were compared between insured and uninsured patients. Multivariable adjustment was performed using linear regression.
Results |
Of 76 patients who met eligibility, 44 had insurance and 32 were uninsured (NOINSUR). Despite having similar ventilator days (13 vs. 12.1) and ICU LOS (20.1 vs. 16.8), the NOINSUR group had more ventilator-free days (22.3 vs 6.6; p < 0.0001), longer Stepdown Unit length of stay (10.2 vs 2.3; p = 0.0036), and a longer hospital length of stay (35.3 vs 18.7; p = 0.0062).
Conclusion |
Uninsured SCI patients face longer hospital LOS due to their insurance status and lack of funding for timely rehabilitation placement. This utilizes valuable hospital resources and puts them at risk for hospital related complications and further increased healthcare expenditures.
El texto completo de este artículo está disponible en PDF.Highlights |
• | No difference in ventilator or ICU days between SCI payer source groups. |
• | Uninsured SCI patients face longer hospital LOS due to their insurance status. |
• | Uninsured SCI patients are less likely to be discharged to rehabilitation facility. |
Esquema
Vol 217 - N° 6
P. 1060-1064 - juin 2019 Regresar al número
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- Impact of the Affordable Care Act on elective general surgery clinical practice
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Bienvenido a EM-consulte, la referencia de los profesionales de la salud.
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