Evidence map›Paper›PMID 33849732›Full record

ArticleSurgery2021

The coronavirus disease 2019 (COVID-19) stay-at-home order's unequal effects on trauma volume by insurance status in Southern California.

Eric O Yeates, Catherine Juillard, Areg Grigorian, Morgan Schellenberg, Natthida Owattanapanich, Galinos Barmparas, Daniel Margulies, Kent Garber, Henry Cryer, Areti Tillou and 22 more

Abstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Surgery, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed.

  1. Article
  2. Review
  3. Article
  4. Article
  5. Article
  6. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

32 authors.

Eric O YeatesUniversity of California, Irvine (UCI), Department of Surgery, Orange, CA.
Catherine JuillardUniversity of California, Los Angeles (UCLA), Department of Surgery, Los Angeles, CA.
Areg GrigorianUniversity of California, Irvine (UCI), Department of Surgery, Orange, CA; University of Southern California (USC), Department of Surgery, Los Angeles, CA.
Morgan SchellenbergUniversity of Southern California (USC), Department of Surgery, Los Angeles, CA.
Natthida OwattanapanichUniversity of Southern California (USC), Department of Surgery, Los Angeles, CA.
Galinos BarmparasCedars-Sinai Medical Center, Department of Surgery, Los Angeles, CA.
Daniel MarguliesCedars-Sinai Medical Center, Department of Surgery, Los Angeles, CA.
Kent GarberUniversity of California, Los Angeles (UCLA), Department of Surgery, Los Angeles, CA.
Henry CryerUniversity of California, Los Angeles (UCLA), Department of Surgery, Los Angeles, CA.
Areti TillouUniversity of California, Los Angeles (UCLA), Department of Surgery, Los Angeles, CA.
Sigrid BurrussLoma Linda University, Department of Surgery, Loma Linda, CA.
Liz Penaloza-VillalobosLoma Linda University, Department of Surgery, Loma Linda, CA.
Ann LinLoma Linda University, Department of Surgery, Loma Linda, CA.
Ryan Arthur FiguerasLoma Linda University, Department of Surgery, Loma Linda, CA.
Megan BrennerUniversity of California, Riverside/Riverside University Health System Department of Surgery, Moreno Valley, CA.
Christopher FirekComparative Effectiveness and Clinical Outcomes Research Center (CECORC), Riverside University Health System, Moreno Valley, CA.
Todd CostantiniUniversity of California, San Diego (UCSD), Department of Surgery, San Diego, CA.
Jarrett SantorelliUniversity of California, San Diego (UCSD), Department of Surgery, San Diego, CA.
Terry CurryUniversity of California, San Diego (UCSD), Department of Surgery, San Diego, CA.
Diane WintzSharp Memorial Hospital, Department of Surgery, San Diego, CA.
Walter L BifflScripps Memorial Hospital La Jolla, Trauma Department, La Jolla, CA.
Kathryn B SchafferScripps Memorial Hospital La Jolla, Trauma Department, La Jolla, CA.
Thomas K DuncanVentura County Medical Center, Department of Surgery, Ventura, CA.
Casey BarbaroVentura County Medical Center, Department of Surgery, Ventura, CA.
Graal DiazVentura County Medical Center, Department of Surgery, Ventura, CA.
Arianne JohnsonSanta Barbara Cottage Hospital, Cottage Health Research Institute, Santa Barbara, CA.
Justine ChinnUniversity of California, Irvine (UCI), Department of Surgery, Orange, CA.
Ariana NaasehUniversity of California, Irvine (UCI), Department of Surgery, Orange, CA.
Amanda LeungUniversity of California, Irvine (UCI), Department of Surgery, Orange, CA.
Christina GrabarUniversity of California, Irvine (UCI), Department of Surgery, Orange, CA.
Todd O YeatesUniversity of California, Los Angeles (UCLA), Department of Chemistry and Biochemistry, Los Angeles, CA.
Jeffry NahmiasUniversity of California, Irvine (UCI), Department of Surgery, Orange, CA. Electronic address: jnahmias@hs.uci.edu.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe 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.

methodsA 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.

resultsCompared 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.

conclusionThis 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.

Indexed as

COVID-19QuarantineCaliforniaHealth Status DisparitiesHumansInsurance CoverageRetrospective StudiesTrauma CentersWounds and Injuries

Identifiers

PMID33849732
PMCPMC9757901

What OpenQuestion holds

Textmetadata
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.