Evidence map›Paper›PMID 42011464›Full record

ArticleCureus2026

Health Insurance and Trauma Outcomes: The Impact of Coverage on Survival and Recovery in Craniomaxillofacial Injuries.

Daniela Bresciani, Gabriela Pomales Díaz, Natalia Yordan Fernandez, Deyna Morales Carrasquillo, Cristhian G Negron Rodriguez, Jayson Cotto, Odaly S Balasquide, Guillermo S López, Angel J Carrero Agron, Juan C Berríos Cordero and 5 more

Abstract read
In one paragraph

Article in Cureus, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0citing papers in PubMed
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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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

15 authors.

Daniela BrescianiDepartment of General Surgery, NewYork-Presbyterian Queens, New York, USA.
Gabriela Pomales DíazDepartment of General Surgery, Baylor University Medical Center, Dallas, USA.
Natalia Yordan FernandezDepartment of General Surgery, University of Puerto Rico, Medical Sciences Campus, San Juan, PRI.
Deyna Morales CarrasquilloDepartment of General Surgery, University of Puerto Rico, Medical Sciences Campus, San Juan, PRI.
Cristhian G Negron RodriguezDepartment of General Surgery, University of Puerto Rico, Medical Sciences Campus, San Juan, PRI.
Jayson CottoDepartment of General Surgery, Universidad Central del Caribe, Bayamón, PRI.
Odaly S BalasquideDepartment of General Surgery, University of Puerto Rico, Medical Sciences Campus, San Juan, PRI.
Guillermo S LópezDepartment of General Surgery, University of Puerto Rico, Medical Sciences Campus, San Juan, PRI.
Angel J Carrero AgronDepartment of General Surgery, Universidad Central del Caribe, Bayamón, PRI.
Juan C Berríos CorderoDepartment of General Surgery, University of Puerto Rico, Medical Sciences Campus, San Juan, PRI.
Luis Barreto HolladyDepartment of General Surgery, Universidad Central del Caribe, Bayamón, PRI.
Alejandra Acevedo MuñizDepartment of General Surgery, Universidad Central del Caribe, Bayamón, PRI.
Corally López VegaDepartment of General Surgery, Universidad Central del Caribe, Bayamón, PRI.
Raúl Y Ramos-SánchezDepartment of Otolaryngology - Head and Neck Surgery, University of Puerto Rico, Medical Sciences Campus, San Juan, PRI.
Angel Rivera BarriosDepartment of Plastic Surgery, University of Puerto Rico, Medical Sciences Campus, San Juan, PRI.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Introduction Health disparities, particularly those related to insurance status, significantly impact trauma outcomes. Craniomaxillofacial (CMF) trauma patients without insurance often experience worse outcomes due to limited access to care and delayed treatment. This study examines the effects of insurance coverage on outcomes such as length of stay (LOS), survival, and surgical site infections (SSIs) among CMF trauma patients in Puerto Rico. Methods An institutional review board-approved retrospective analysis was conducted on 1,165 CMF trauma patients treated at the Puerto Rico Medical Center's Department of Trauma from January 2018 to October 2022. Patient demographics, trauma type, insurance coverage, and outcomes were abstracted. Patients were categorized by insurance status: government-only, private-only, government + private, and uninsured. Statistical analyses, including ANOVA, chi-square tests, and t-tests, were performed to assess the relationships between insurance status and LOS, survival, operative status, and SSI. Results Most patients (n = 849, 72.9%) had government insurance only, 60 (5.2%) had government + private, 141 (12.1%) had private only, and 99 (8.5%) were uninsured. Motor vehicle accidents were the leading cause of injury (n = 575, 49.3%). Uninsured patients had shorter LOS (mean 12.43 days) compared to those with government (20.30 days) or private insurance (16.88 days; p = 0.02). There were 84 (9.9%) deaths in the government-only insurance group, 21 (14.9%) in the private-only insurance group, 10 (16.7%) in the government + private insurance group, and 20 (20.2%) in the uninsured group (p = 0.02). While uninsured patients were less likely to undergo surgery, there were no statistically significant differences in operative rates (p = 0.355) or SSI among insurance groups (p = 0.847). Conclusions This study highlights potential disparities in outcomes for CMF trauma patients in Puerto Rico based on insurance status. Government-insured patients had longer LOS but lower mortality, while uninsured patients experienced shorter stays and higher mortality, suggesting potential undertreatment. Expanding insurance coverage and improving follow-up care for uninsured populations could help address these disparities. Further research is needed to identify systemic factors, identify reasons for lack of insurance, and inform equitable trauma care policies.

Indexed as

craniomaxillofacial traumahealth disparitieshealth insurancepuerto ricotrauma outcomes

Identifiers

PMID42011464
PMCPMC13092123

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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.