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The coronavirus disease 2019 (COVID-19) stay-at-home order's unequal effects on trauma volume by insurance status in Southern California.
Yeates, Eric O; Juillard, Catherine; Grigorian, Areg; Schellenberg, Morgan; Owattanapanich, Natthida; Barmparas, Galinos; Margulies, Daniel; Garber, Kent; Cryer, Henry; Tillou, Areti; Burruss, Sigrid; Penaloza-Villalobos, Liz; Lin, Ann; Figueras, Ryan Arthur; Brenner, Megan; Firek, Christopher; Costantini, Todd; Santorelli, Jarrett; Curry, Terry; Wintz, Diane; Biffl, Walter L; Schaffer, Kathryn B; Duncan, Thomas K; Barbaro, Casey; Diaz, Graal; Johnson, Arianne; Chinn, Justine; Naaseh, Ariana; Leung, Amanda; Grabar, Christina; Yeates, Todd O; Nahmias, Jeffry.
Afiliação
  • Yeates EO; University of California, Irvine (UCI), Department of Surgery, Orange, CA.
  • Juillard C; University of California, Los Angeles (UCLA), Department of Surgery, Los Angeles, CA.
  • Grigorian A; University of California, Irvine (UCI), Department of Surgery, Orange, CA; University of Southern California (USC), Department of Surgery, Los Angeles, CA.
  • Schellenberg M; University of Southern California (USC), Department of Surgery, Los Angeles, CA.
  • Owattanapanich N; University of Southern California (USC), Department of Surgery, Los Angeles, CA.
  • Barmparas G; Cedars-Sinai Medical Center, Department of Surgery, Los Angeles, CA.
  • Margulies D; Cedars-Sinai Medical Center, Department of Surgery, Los Angeles, CA.
  • Garber K; University of California, Los Angeles (UCLA), Department of Surgery, Los Angeles, CA.
  • Cryer H; University of California, Los Angeles (UCLA), Department of Surgery, Los Angeles, CA.
  • Tillou A; University of California, Los Angeles (UCLA), Department of Surgery, Los Angeles, CA.
  • Burruss S; Loma Linda University, Department of Surgery, Loma Linda, CA.
  • Penaloza-Villalobos L; Loma Linda University, Department of Surgery, Loma Linda, CA.
  • Lin A; Loma Linda University, Department of Surgery, Loma Linda, CA.
  • Figueras RA; Loma Linda University, Department of Surgery, Loma Linda, CA.
  • Brenner M; University of California, Riverside/Riverside University Health System Department of Surgery, Moreno Valley, CA.
  • Firek C; Comparative Effectiveness and Clinical Outcomes Research Center (CECORC), Riverside University Health System, Moreno Valley, CA.
  • Costantini T; University of California, San Diego (UCSD), Department of Surgery, San Diego, CA.
  • Santorelli J; University of California, San Diego (UCSD), Department of Surgery, San Diego, CA.
  • Curry T; University of California, San Diego (UCSD), Department of Surgery, San Diego, CA.
  • Wintz D; Sharp Memorial Hospital, Department of Surgery, San Diego, CA.
  • Biffl WL; Scripps Memorial Hospital La Jolla, Trauma Department, La Jolla, CA.
  • Schaffer KB; Scripps Memorial Hospital La Jolla, Trauma Department, La Jolla, CA.
  • Duncan TK; Ventura County Medical Center, Department of Surgery, Ventura, CA.
  • Barbaro C; Ventura County Medical Center, Department of Surgery, Ventura, CA.
  • Diaz G; Ventura County Medical Center, Department of Surgery, Ventura, CA.
  • Johnson A; Santa Barbara Cottage Hospital, Cottage Health Research Institute, Santa Barbara, CA.
  • Chinn J; University of California, Irvine (UCI), Department of Surgery, Orange, CA.
  • Naaseh A; University of California, Irvine (UCI), Department of Surgery, Orange, CA.
  • Leung A; University of California, Irvine (UCI), Department of Surgery, Orange, CA.
  • Grabar C; University of California, Irvine (UCI), Department of Surgery, Orange, CA.
  • Yeates TO; University of California, Los Angeles (UCLA), Department of Chemistry and Biochemistry, Los Angeles, CA.
  • Nahmias J; University of California, Irvine (UCI), Department of Surgery, Orange, CA. Electronic address: jnahmias@hs.uci.edu.
Surgery ; 170(3): 962-968, 2021 09.
Article em En | MEDLINE | ID: mdl-33849732
ABSTRACT

BACKGROUND:

The rapid spread of coronavirus disease 2019 in the United States led to a variety of mandates intended to decrease population movement and "flatten the curve." However, there is evidence some are not able to stay-at-home due to certain disadvantages, thus remaining exposed to both coronavirus disease 2019 and trauma. We therefore sought to identify any unequal effects of the California stay-at-home orders between races and insurance statuses in a multicenter study utilizing trauma volume data.

METHODS:

A posthoc multicenter retrospective analysis of trauma patients presenting to 11 centers in Southern California between the dates of January 1, 2020, and June 30, 2020, and January 1, 2019, and June 30, 2019, was performed. The number of trauma patients of each race/insurance status was tabulated per day. We then calculated the changes in trauma volume related to stay-at-home orders for each race/insurance status and compared the magnitude of these changes using statistical resampling.

RESULTS:

Compared to baseline, there was a 40.1% drop in total trauma volume, which occurred 20 days after stay-at-home orders. During stay-at-home orders, the average daily trauma volume of patients with Medicaid increased by 13.7 ± 5.3%, whereas the volume of those with Medicare, private insurance, and no insurance decreased. The average daily trauma volume decreased for White, Black, Asian, and Latino patients with the volume of Black and Latino patients dropping to a similar degree compared to White patients.

CONCLUSION:

This retrospective multicenter study demonstrated that patients with Medicaid had a paradoxical increase in trauma volume during stay-at-home orders, suggesting that the most impoverished groups remain disproportionately exposed to trauma during a pandemic, further exacerbating existing health disparities.
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Texto completo: 1 Base de dados: MEDLINE Assunto principal: Centros de Traumatologia / Ferimentos e Lesões / Quarentena / Cobertura do Seguro / COVID-19 Tipo de estudo: Observational_studies / Risk_factors_studies Limite: Humans País como assunto: America do norte Idioma: En Ano de publicação: 2021 Tipo de documento: Article
Texto completo
Imprimir
XML
PubMed Links
Buscar no Google

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Centros de Traumatologia / Ferimentos e Lesões / Quarentena / Cobertura do Seguro / COVID-19 Tipo de estudo: Observational_studies / Risk_factors_studies Limite: Humans País como assunto: America do norte Idioma: En Ano de publicação: 2021 Tipo de documento: Article