ArticleInjury2016
Uninsured status may be more predictive of outcomes among the severely injured than minority race.
Article in Injury, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
12 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Disparities in Adult and Pediatric Trauma Outcomes: a Systematic Review and Meta-Analysis.World journal of surgery · 2020Pooled it
- Disparities in Surgical Access: A Systematic Literature Review, Conceptual Model, and Evidence Map.Journal of the American College of Surgeons · 2019Pooled it
- Understanding disparities in firearm mortality: The role of person- and place-based factors.Injury · 2025Article
- The Impact of Social Deprivation on Health Care Utilization Patterns Following Closed Reduction and Percutaneous Pinning of Pediatric Supracondylar Humerus Fractures.Journal of the Pediatric Orthopaedic Society of North America · 2024Article
- Insurance Type and Withdrawal of Life-Sustaining Therapy in Critically Injured Trauma Patients.JAMA network open · 2024Article
- Community-Level Social Vulnerability and Patterns of Adolescent Injury.Annals of surgery open : perspectives of surgical history, education, and clinical approaches · 2023Article
- Impact of Medicaid expansion on young adult firearm and motor vehicle crash trauma patients.Surgery open science · 2022Article
- Trends in COVID-19 Health Disparities in North Carolina: Preparing the Field for Long-Haul Patients.Healthcare (Basel, Switzerland) · 2021Article
- Racial disparities in mortality after severe traumatic brain injury in childhood: mediators identified by Oaxaca-Blinder decomposition of trauma registry data.Injury epidemiology · 2021Article
- The Affordable Care Act's Effect on Discharge Disposition of Racial Minority Trauma Patients in the United States.Journal of racial and ethnic health disparities · 2019Article
- Association of Medicaid Expansion Under the Affordable Care Act With Outcomes and Access to Rehabilitation in Young Adult Trauma Patients.JAMA surgery · 2018Article
- Association of Expanded Medicaid Coverage With Hospital Length of Stay After Injury.JAMA surgery · 2017Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors.
Funding
Abstract
aimWorse outcomes in trauma in the United States have been reported for both the uninsured and minority race. We sought to determine whether disparities would persist among severely injured patients treated at trauma centres where standard triage trauma protocols limit bias from health systems and providers.
methodsWe performed a retrospective analysis of the 2010-2012 National Sample Program from the National Trauma Databank, which is a nationally representative sample of trauma centre performance in the United States. The database was screened for adults ages 18-64 who had a known insurance status. Outcomes measured were in-hospital mortality and post-hospital care.
resultsThere were 739,149 injured patients included in the analysis. Twenty-eight percent were uninsured, and 34 percent were of minority race. In the adjusted analysis, uninsured status (OR 1.60, 1.29-1.98, p<0.001) and black race (OR 1.24, 1.04-1.49, p=0.019) were significant predictors of mortality. Only uninsured status was a significant negative predictor of post-hospital care (OR 0.43, 0.36-0.51, p<0.001). As injury severity increased, only insurance status was a significant predictor of both increased mortality (OR 1.68, 1.29-2.19, p<0.001) and decreased post-hospital care (OR 0.45, 0.32-0.63, p<0.001).
conclusionUninsured status is independently associated with higher in-hospital mortality and decreased post-hospital care in patients with severe injuries in a nationally representative sample of trauma centres in the United States. Increased in-hospital mortality is likely due to endogenous patient factors while decreased post-hospital care is likely due to economic constraints. Minority race is less of a factor influencing disparate outcomes among the severely injured.
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Registered trials
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