The Affordable Care Act and its association with length of stay and payer status for trauma patients at a level I trauma center.
Am J Surg
; 213(5): 870-873, 2017 May.
Article
em En
| MEDLINE
| ID: mdl-28438261
ABSTRACT
BACKGROUND:
We hypothesized that the ACA would shorten length of stay and increase numbers of insured patients without changing trauma patient outcomes.METHODS:
A retrospective review of adult trauma patients admitted to a level I trauma center between 2012 and 2014 was performed. Demographics, length of stay, payer status, discharge disposition, and complications before and after the ACA implementation were analyzed.RESULTS:
4448 trauma patients were admitted during the study period. Patients treated after ACA implementation were older (53 vs 51, p = 0.05) with shorter ICU stays (1.7 vs 1.5 days, p = 0.04), but longer overall hospital stays (3.7 vs 4.1 days, p < 0.01). The proportion of self-pay patients decreased 11%-3% (p=<0.001). A higher proportion of patients were discharged to skilled nursing facilities (SNF, 17.1% vs 19.9%, p = 0.02). There was no change in rates of death, readmission, infection, pneumonia or decubiti.CONCLUSION:
Among trauma patients, there was a decrease in self-pay status and increase in public insurance without change in private insurance after implementation of the ACA. More patients were discharged to SNF without changes in reported outcomes.Palavras-chave
Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Centros de Traumatologia
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Ferimentos e Lesões
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Pessoas sem Cobertura de Seguro de Saúde
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Cobertura do Seguro
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Patient Protection and Affordable Care Act
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Tempo de Internação
Idioma:
En
Ano de publicação:
2017
Tipo de documento:
Article