ArticleSpine2016
The Influence of Insurance Status on the Surgical Treatment of Acute Spinal Fractures.
Article in Spine, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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Who cites it
12 citing papers in PubMed.
- The Impact of Socioeconomic Disadvantage and Insurance on Delays in Fixation of Distal Radius Fractures.Hand (New York, N.Y.) · 2026Article
- Child Opportunity Index Predicts Outcomes in Pediatric Spine Trauma: A Novel Application of Social Determinants of Health.Children (Basel, Switzerland) · 2025Article
- Epidemiological investigation of traumatic spinal cord injury caused by object strike in China: strategies for workplace safety improvement.Journal of rehabilitation medicine · 2024Article
- Socioeconomic differences in access to scoliosis care in the pediatric population.Spine deformity · 2024Article
- Influence of socioeconomic factors on discharge disposition following traumatic cervicothoracic spinal cord injury at level I and II trauma centers in the United States.North American Spine Society journal · 2022Article
- Socioeconomic and geographic disparities in pediatric scoliosis surgery.Spine deformity · 2022Article
- Artificial Intelligence Accurately Detects Traumatic Thoracolumbar Fractures on Sagittal Radiographs.Medicina (Kaunas, Lithuania) · 2022Article
- Predictors of Surgery and Cost of Care Associated with Patellar Instability in the Pediatric and Young Adult Population.Arthroscopy, sports medicine, and rehabilitation · 2021Article
- Influence of psychosocial and sociodemographic factors in the surgical management of traumatic cervicothoracic spinal cord injury at level I and II trauma centers in the United States.Journal of spine surgery (Hong Kong) · 2021Article
- Variability in time to surgery for patients with acute thoracolumbar spinal cord injuries.Scientific reports · 2021Article
- National incidence of traumatic spinal fractures in China: Data from China National Fracture Study.Medicine · 2018Article
- Traumatic upper cervical spinal fractures in teaching hospitals of China over 13 years: A retrospective observational study.Medicine · 2016Observational
Corrections and comments
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Authors and funding
4 authors.
Funding
Abstract
STUDY
designA retrospective, propensity score, multivariate analysis of the National Trauma Data Bank (NTDB) between 2008 and 2011.
objectiveThe aim of this study was to determine the relationship between insurance status and rates of surgery for acute spinal fractures with and without spinal cord injury (SCI). SUMMARY OF BACKGROUND DATA: The decision for surgery in patients with spinal fractures is often based on fracture pattern and stability, associated SCI, and the presence of ligamentous and other associated injuries. It is poorly understood how nonclinical factors, such as insurance status, influence the decision for surgical intervention in patients sustaining spinal trauma.
methodsUsing NTDB admission years 2008 to 2011, we included patients 18 to 64 years old who sustained a fracture of the cervical or thoracolumbar spine. Patients were excluded if they sustained polytrauma (Injury Severity Score ≥27) or a major injury (Abbreviated Injury Scale severity ≥3) to the head, thorax, or abdomen. Our main outcome measure was surgical versus nonsurgical treatment for spinal injury; our main predictor was insurance status. Hierarchical multivariate regression analysis and propensity scores were used to determine the relationship between insurance status and surgical treatment, controlling for other factors. We calculated adjusted odds ratios (ORs) for rates of surgery.
resultsOur propensity score multivariate analysis demonstrated significantly higher rates of surgery in patients with SCI (OR = 11.76, P < 0.001), insurance (OR = 1.27, P < 0.001), white (OR = 1.21, P = 0.018) versus black race, blunt trauma (OR = 5.63, P < 0.001), shock (OR = 1.62, P < 0.001), higher Glasgow Coma Scale (GCS) score (OR = 1.02, P = 0.002), transfer from lower acuity hospital (OR = 1.51, P < 0.001), and treatment at teaching hospitals (OR = 1.49, P < 0.001). Multivariable subgroup analysis of SCI patients similarly revealed higher surgical rates for insured patients (OR = 1.46, P < 0.001) than those without insurance.
conclusionPatients with traumatic spine fractures were more likely to receive surgery if they were insured, regardless of the presence of SCI.
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