Evidence map›Paper›PMID 39522138›Full record

ArticleBurns : journal of the International Society for Burn Injuries2025

The impact of insurance disparities on long-term burn outcomes: A Burn Model System investigation.

Anupama Mehta, Manuel Castillo-Angeles, Lauren J Shepler, Gretchen J Carrougher, Nicole S Gibran, Barclay T Stewart, Steven E Wolf, Karen Kowalske, Colleen M Ryan, Jeffrey C Schneider

Abstract read
In one paragraph

Article in Burns : journal of the International Society for Burn Injuries, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing 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

1 citing paper in PubMed.

  1. 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

10 authors.

Anupama MehtaDivision of Trauma, Burn, and Surgical Critical Care, Department of Surgery, Brigham and Women's Hospital, Boston, MA, United States. Electronic address: amehta15@bwh.harvard.edu.
Manuel Castillo-AngelesDivision of Trauma, Burn, and Surgical Critical Care, Department of Surgery, Brigham and Women's Hospital, Boston, MA, United States; Center for Surgery and Public Health, Department of Surgery, Brigham and Women's Hospital, Boston, MA, United States. Electronic address: mcastillo@bwh.harvard.edu.
Lauren J SheplerDepartment of Physical Medicine and Rehabilitation, Spaulding Research Institute, Spaulding Rehabilitation Hospital, Boston, MA, United States. Electronic address: lshepler@mgb.org.
Gretchen J CarrougherDepartment of Surgery, The University of Washington, Seattle, WA, United States. Electronic address: carrough@uw.edu.
Nicole S GibranDepartment of Surgery, The University of Washington, Seattle, WA, United States. Electronic address: nicoleg@uw.edu.
Barclay T StewartDepartment of Surgery, The University of Washington, Seattle, WA, United States; Harborview Injury Prevention and Research Center, Seattle, WA, United States. Electronic address: barclays@uw.edu.
Steven E WolfUniversity of Texas Medical Branch, Galveston, TX, United States. Electronic address: swolf@utmb.edu.
Karen KowalskeDepartment of Surgery, The University of Texas Southwestern Medical Center, Dallas-Fort Worth, TX, United States. Electronic address: karen.kowalske@UTSouthwestern.edu.
Colleen M RyanDepartment of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States; Shriners Hospitals for Children's-Boston, Boston, MA, United States. Electronic address: cryan@mgh.harvard.edu.
Jeffrey C SchneiderDepartment of Physical Medicine and Rehabilitation, Spaulding Research Institute, Spaulding Rehabilitation Hospital, Boston, MA, United States; Department of Physical Medicine and Rehabilitation, Massachusetts General Hospital, Boston, MA, United States. Electronic address: jcschneider@mgh.harvard.edu.

Funding

ACL HHS 90DPBU0001ACL HHS 90DPBU0005ACL HHS 90DPBU0008
6 · The paper itself

Abstract

introductionAccess to healthcare and insurance coverage are associated with quality of life, morbidity, and mortality outcomes. However, most studies have only focused on same-admission and short-term outcomes due to the lack of national longitudinal datalthere are limited data on this topic in the burn literature. Our aim was to determine the effect of insurance status on long-term outcomes in a national sample of burn patients.

methodsThis retrospective study used the longitudinal Burn Model System National Database from January 1997 to December 2020. The inclusion criteria were all adult patients admitted for burn injury from participating sites. Main outcomes were the physical (PCS) and mental (MCS) health component summary scores of the Veterans RAND 12 (VR-12) score at 6, 12, and 24 months after injury. Adjusting for demographic and clinical characteristics, multivariable regression was used to examine the association between insurance status and the outcomes.

resultsA total of 1809 burn patients were included. Most patients had private/commercial insurance (60.42 %), followed by Medicare (13.99 %) and Medicaid (12.77 %). The remaining 13 % were uninsured patients (self-pay or philanthropy). In adjusted analyses, Medicaid insurance was associated with worse MCS at 6 months (Coefficient -4.24, 95 % CI -6.06 - -2.41) and 12 months (Coefficient -3.62, 95 % CI -5.68 - -1.57), and worse PCS at all timepoints, compared to private/commercial insurance. Medicare insurance was associated with worse MCS scores at 12 months (Coefficient -2.86, 95 % CI -5.06 - -0.66) and worse PCS scores at all timepoints.

conclusionHaving Medicaid and Medicare insurance was significantly associated with a lower health-related quality of life at long-term follow up, even after adjusting for demographics and burn injury severity.

Indexed as

BurnsHealthcare DisparitiesInsurance CoverageInsurance, HealthAdultAgedFemaleHumansMaleMedicaidMedically UninsuredMedicareMiddle AgedQuality of LifeRetrospective StudiesUnited StatesBurn injuryDisparitiesInsuranceOutcomes

Identifiers

PMID39522138
PMCPMC11741934

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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.