The severity of disparity: increasing injury intensity accentuates disparate outcomes following trauma.
J Health Care Poor Underserved
; 25(1): 308-20, 2014 Feb.
Article
em En
| MEDLINE
| ID: mdl-24509028
ABSTRACT
OBJECTIVE:
Studies have shown disparities in mortality among racial groups and among those with differing insurance coverage. Our goal was to determine if injury severity affects these disparities.METHODS:
We classified patients from the 2003-2008 National Trauma Data Banks suffering moderate to severe injuries into six groups based on race/ethnicity and insurance, stratifying by injury severity. Logistic regression compared odds of death between races-ethnicities/insurance groups within these strata. We adjusted for age, gender, Injury Severity Score, Glasgow Coma Scale motor component, hypotension, and mechanism of injury.RESULTS:
Patients meeting inclusion criteria numbered 760,598. Disparities between races-ethnicities/insurance groups increased as injury severity worsened. Odds of death for uninsured Black patients compared with insured Whites increased from 1.82 among moderately injured patients to 3.14 among severely injured, hypotensive patients. A similar pattern was seen among uninsured Hispanic patients.CONCLUSIONS:
Disparities in trauma mortality suffered by minority and uninsured patients, when compared with non-minority and insured patients, worsen with increasing injury.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Ferimentos e Lesões
/
Escala de Gravidade do Ferimento
/
Pessoas sem Cobertura de Seguro de Saúde
/
Disparidades em Assistência à Saúde
Tipo de estudo:
Observational_studies
/
Risk_factors_studies
Aspecto:
Determinantes_sociais_saude
Limite:
Adolescent
/
Adult
/
Female
/
Humans
/
Male
País/Região como assunto:
America do norte
Idioma:
En
Revista:
J Health Care Poor Underserved
Assunto da revista:
SERVICOS DE SAUDE
Ano de publicação:
2014
Tipo de documento:
Article