American journal of surgery · 2018
The paralyzing effect of insurance status on throughput of acute spinal cord patients.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Lindemuth Mary, Garwe Tabitha, Venincasa Kiran, Zander Tyler, McCarthy Cullen, Bonds Morgan, Sarwar Zoona, Albrecht Roxie, Lees Jason, Scifres Aaron, Cross Alisa
Аннотация
OBJECTIVE: To determine whether lack of insurance is a predictor of poor outcomes and increased healthcare expenditure for SCI patients.
METHODS: Retrospective cohort study of trauma patients admitted with an acute, severe (AIS ≥ 3) SCI and admission score of ASIA-A to a Level 1 trauma center (2012-2016). Patient characteristics and outcomes (LOS, complications) were compared between insured and uninsured patients. Multivariable adjustment was performed using linear regression.
RESULTS: Of 76 patients who met eligibility, 44 had insurance and 32 were uninsured (NOINSUR). Despite having similar ventilator days (13 vs. 12.1) and ICU LOS (20.1 vs. 16.8), the NOINSUR group had more ventilator-free days (22.3 vs 6.6; p < 0.0001), longer Stepdown Unit length of stay (10.2 vs 2.3; p = 0.0036), and a longer hospital length of stay (35.3 vs 18.7; p = 0.0062).
CONCLUSION: Uninsured SCI patients face longer hospital LOS due to their insurance status and lack of funding for timely rehabilitation placement. This utilizes valuable hospital resources and puts them at risk for hospital related complications and further increased healthcare expenditures.
METHODS: Retrospective cohort study of trauma patients admitted with an acute, severe (AIS ≥ 3) SCI and admission score of ASIA-A to a Level 1 trauma center (2012-2016). Patient characteristics and outcomes (LOS, complications) were compared between insured and uninsured patients. Multivariable adjustment was performed using linear regression.
RESULTS: Of 76 patients who met eligibility, 44 had insurance and 32 were uninsured (NOINSUR). Despite having similar ventilator days (13 vs. 12.1) and ICU LOS (20.1 vs. 16.8), the NOINSUR group had more ventilator-free days (22.3 vs 6.6; p < 0.0001), longer Stepdown Unit length of stay (10.2 vs 2.3; p = 0.0036), and a longer hospital length of stay (35.3 vs 18.7; p = 0.0062).
CONCLUSION: Uninsured SCI patients face longer hospital LOS due to their insurance status and lack of funding for timely rehabilitation placement. This utilizes valuable hospital resources and puts them at risk for hospital related complications and further increased healthcare expenditures.