Impact of primary payer status on outcomes among patients with burn injury: A nationwide analysis

Heather Peluso, Marwan S. Abougergi, Julie Caffrey

Research output: Contribution to journalArticlepeer-review

Abstract

Objective: To study the relationship between insurance provider and important outcomes among patients with burn injury. Methods: Adults with burn injury were selected from the National Inpatient Sample. The primary outcome was inpatient mortality. Secondary outcomes were morbidity (septic shock and prolonged mechanical ventilation (PMV)), treatment metrics (time to surgery and parenteral or enteral nutrition (P/E-nutrition)) and resource utilization (length of stay (LOS) and total hospitalization costs and charges). Confounders were adjusted for using multivariate regression analysis. Results: Insurance did not affect in-hospital mortality rate. Compared with private insurance, Medicaid was associated with higher septic shock rate (aOR: 2.14 (1.04–4.39), longer LOS (adjusted mean difference (aMD): 2.79 (0.50–5.08) days) and higher costs (aMD: $16,161 ($4789–$27,534) while uninsured patients has shorter LOS (aMD: −2.57 (−4.59–−0.55) days), lower charges (aMD: $−37,792 $(−65,550–$−10,034) and costs (aMD: $−8563 ($15,581–$−1544)). Insurance did not affect PMV rates or time to surgery or P/E-nutrition. Conclusions: Primary payer does not affect in-hospital mortality or treatment metrics among patients admitted for burn injury. However, compared with private insurance, Medicaid was associated with both higher morbidity and resource utilization, whereas uninsured patients had lower resource utilization.

Original languageEnglish (US)
Pages (from-to)1973-1981
Number of pages9
JournalBurns
Volume44
Issue number8
DOIs
StatePublished - Dec 2018

Keywords

  • Burn injury
  • Mortality
  • Outcomes
  • Primary payer
  • Resource utilization

ASJC Scopus subject areas

  • Surgery
  • Emergency Medicine
  • Critical Care and Intensive Care Medicine

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