Disparities in trauma care: Are fewer diagnostic tests conducted for uninsured patients with pelvic fracture?

Oluwaseyi B. Bolorunduro, Adil H. Haider, Tolulope A. Oyetunji, Amal Khoury, Maricel Cubangbang, Elliott Haut, Wendy R. Greene, David C. Chang, Edward E. Cornwell, Suryanarayana M. Siram

Research output: Contribution to journalArticle

Abstract

Background: Research from other medical specialties suggests that uninsured patients experience treatment delays, receive fewer diagnostic tests, and have reduced health literacy when compared with their insured counterparts. We hypothesized that these disparities in interventions would not be present among patients experiencing trauma. Our objective was to examine differences in diagnostic and therapeutic procedures administered to patients undergoing trauma with pelvic fractures using a national database. Methods: A retrospective analysis was conducted using the National Trauma Data Bank (NTDB), 2002 to 2006. Patients aged 18 to 64 years who experienced blunt injuries with pelvic fractures were analyzed. Patients who were dead on arrival, those with an injury severity score (ISS) less than 9, those with traumatic brain injury, and patients with burns were excluded. The likelihood of the uninsured receiving select diagnostic and therapeutic procedures was compared with the same likelihood in the insured. Multivariate analysis for mortality was conducted, adjusting for age, sex, race, ISS, presence of shock, Glasgow Coma Scale (GCS) motor score, and mechanism of injury. Results: Twenty-one thousand patients met the inclusion criteria: 82% of these patients were insured and 18% were uninsured. There was no clinical difference in ISSs (21 vs 20), but the uninsured were more likely to present in shock (P

Original languageEnglish (US)
Pages (from-to)365-370
Number of pages6
JournalAmerican Journal of Surgery
Volume205
Issue number4
DOIs
StatePublished - Apr 2013

Fingerprint

Routine Diagnostic Tests
Wounds and Injuries
Injury Severity Score
Shock
Databases
Health Literacy
Nonpenetrating Wounds
Glasgow Coma Scale
Burns
Therapeutics
Multivariate Analysis
Medicine
Mortality
Research

Keywords

  • Diagnostic tests
  • Disparities
  • Pelvic fracture
  • Procedures
  • Trauma
  • Uninsured

ASJC Scopus subject areas

  • Surgery

Cite this

Disparities in trauma care : Are fewer diagnostic tests conducted for uninsured patients with pelvic fracture? / Bolorunduro, Oluwaseyi B.; Haider, Adil H.; Oyetunji, Tolulope A.; Khoury, Amal; Cubangbang, Maricel; Haut, Elliott; Greene, Wendy R.; Chang, David C.; Cornwell, Edward E.; Siram, Suryanarayana M.

In: American Journal of Surgery, Vol. 205, No. 4, 04.2013, p. 365-370.

Research output: Contribution to journalArticle

Bolorunduro, OB, Haider, AH, Oyetunji, TA, Khoury, A, Cubangbang, M, Haut, E, Greene, WR, Chang, DC, Cornwell, EE & Siram, SM 2013, 'Disparities in trauma care: Are fewer diagnostic tests conducted for uninsured patients with pelvic fracture?', American Journal of Surgery, vol. 205, no. 4, pp. 365-370. https://doi.org/10.1016/j.amjsurg.2012.10.026
Bolorunduro, Oluwaseyi B. ; Haider, Adil H. ; Oyetunji, Tolulope A. ; Khoury, Amal ; Cubangbang, Maricel ; Haut, Elliott ; Greene, Wendy R. ; Chang, David C. ; Cornwell, Edward E. ; Siram, Suryanarayana M. / Disparities in trauma care : Are fewer diagnostic tests conducted for uninsured patients with pelvic fracture?. In: American Journal of Surgery. 2013 ; Vol. 205, No. 4. pp. 365-370.
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