Evidence map›Paper›PMID 37095520›Full record

ArticleBMC health services research2023

Insurance status and traumatized patients' outcomes: a report from the national trauma registry of Iran.

Khatereh Isazadehfar, Payman Salamati, Mohammad Reza Zafarghandi, Vafa Rahimi-Movaghar, Moein Khormali, Vali Baigi

Abstract read
In one paragraph

Article in BMC health services research, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed, 1 pooled it
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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

1 citing paper in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
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

6 authors.

Khatereh IsazadehfarSocial Determinants of Health Research Center (SDH), Medical Faculty, Ardabil University of Medical Sciences, Ardabil, Iran.
Payman SalamatiSina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran.
Mohammad Reza ZafarghandiSina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran.
Vafa Rahimi-MovagharSina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran.ORCID http://orcid.org/0000-0001-7347-8767
Moein KhormaliSina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran.
Vali BaigiSina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran. v-baigi@sina.tums.ac.ir.ORCID http://orcid.org/0000-0003-1882-7340

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundTrauma care is one of the most expensive medical procedures that is significantly affected by factors like insurance status. Providing medical care to injured patients has a significant impact on patients' prognosis. This study examined whether insurance status was associated with different outcomes, including hospital length of stay (HLOS), mortality, and Intensive Care Unit (ICU) admission.

methodsThis prospective study analyzed the data of traumatized patients who had been registered in the National Trauma Registry of Iran (NTRI), and hospitalized at Sina Hospital, Tehran, Iran, from March 22, 2016, to February 8, 2021. Given the type of insurance, the insured patients were classified as basic, road traffic, and foreign nationality. The outcomes of in-hospital death, ICU admission, and HLOS between insured and uninsured patients, and then different insurance statuses, were compared using regression models.

resultA total of 5014 patients were included in the study. 49% of patients (n = 2458) had road traffic insurance, 35.2% (n = 1766) basic insurance, 10.5% (n = 528) were uninsured, and 5.2% (n = 262) had foreign nationality insurance. The mean age of patients with basic, road traffic insurance, foreign nationality, and uninsured patients was 45.2 (SD = 22.3), 37.8 (SD = 15.8), 27.8 (SD = 13.3), and 32.4 (SD = 11.9) years, respectively. There was a statistically significant association between insurance status and mean age. Based on these results, the mean age of patients with basic insurance was higher than other groups (p < 0.001). Additionally, 85.6% of the patients were male, with male to female ratio of 9.64 in road traffic insurance, 2.99 in basic insurance, 14.4 in foreign nationality, and 16 in uninsured patients. There was no statistically significant difference between in-hospital mortality in insured and uninsured patients, 98 (2.3%) vs. 12 (2.3%), respectively. The odds of in-hospital mortality in uninsured patients were 1.04 times the odds of in-hospital death in insured patients [Crude OR: 1.04, 95%CI: 0.58 to 1.90]. Multiple logistic regression showed that after adjusting for age, sex, ISS, and Cause of trauma, the odds of in-hospital death in uninsured patients were 2.97 times the odds of in-hospital death in insured patients [adjusted OR: 2.97, 95%CI: 1.43 to 6.21].

conclusionThis study shows that having insurance can change the ICU admission, death, and HLOS in traumatized patients. The results of this study can provide essential data for national health policy for minimizing the disparities among different insurance statuses and proper use of medical resources.

Indexed as

Insurance CoverageMedically UninsuredFemaleHospital MortalityHumansInsurance, HealthIranMaleProspective StudiesRegistriesRetrospective StudiesUnited StatesAdmissionInsurance coverageLength of stayOutcomeTrauma

Identifiers

PMID37095520
PMCPMC10124013

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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.