560 results match your criteria uninsured trauma


Increased Mortality in Underinsured Penetrating Trauma Patients.

Am Surg 2021 Jun 15:31348211024974. Epub 2021 Jun 15.

Division of Trauma, Burns and Surgical Critical Care, Department of Surgery, University of California, Irvine, Orange, CA, USA.

Introduction: It remains unclear whether an increased mortality risk in uninsured patients exists across Injury Severity Score (ISS) classifications. We hypothesized that penetrating trauma self-pay patients would have a similarly increased mortality risk across all ISS categories.

Methods: The National Trauma Data Bank (2013-2015) was queried for patients presenting with penetrating firearm, explosive, or stab wound injuries. Read More

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Hyperbaric oxygen and mortality in burns with inhalation injury: a study of the National Burn Repository.

J Burn Care Res 2021 Jun 9. Epub 2021 Jun 9.

Hennepin County Medical Center, 701 Park Ave, Minneapolis, MN.

Introduction: Mortality in burn injury is primarily influenced by three factors: age, percent burn (%TBSA), and presence of inhalation injury. Numerous modalities have been tried in an attempt to treat those patients with burns and inhalation injury, including the use of hyperbaric oxygen (HBO). The aim of our study was to find the national prevalence of HBO for burns with inhalation injury, and whether HBO influenced mortality in these often severely-injured patients. Read More

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The Impact of COVID-19 Infection on Outcomes After Injury in a State Trauma System.

J Trauma Acute Care Surg 2021 Jun 1. Epub 2021 Jun 1.

Division of Traumatology, Surgical Critical Care, and Emergency Surgery, University of Pennsylvania Department of Surgery, Reading Hospital and Medical Center Division of Trauma and Acute Care Surgery, Lehigh Valley Health Network Department of Surgery, University of Pennsylvania Department of Surgery, Crozer-Chester Medical Center Department of Research & Innovation, St. Luke's University Health Network, Bethlehem, PA Division of Traumatology, Surgical Critical Care, and Emergency Surgery, University of Pennsylvania

Background: The COVID-19 pandemic reshaped the healthcare system in 2020. COVID-19 infection has been associated with poor outcomes after orthopedic surgery and elective, general surgery, but the impact of COVID-19 on outcomes after trauma is unknown.

Methods: We conducted a retrospective cohort study of patients admitted to Pennsylvania trauma centers from March 21-July 31, 2020. Read More

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Insurance Status Impacts Hospital Discharge for Penetrating Trauma Survivors.

Am Surg 2021 May 29:31348211023396. Epub 2021 May 29.

Department of Surgery, 6566Einstein Medical Center, Philadelphia, PA, USA.

Background: Despite equalized acute care in trauma, disparities exist in the long-term outcomes of trauma survivors. Prior studies have revealed insurance status plays a role in the discharge destination of blunt trauma survivors. This is yet to be described in patients with penetrating traumatic injury. Read More

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Does the insurance status influence in-hospital outcome? A retrospective assessment in 30,175 surgical trauma patients in Switzerland.

Eur J Trauma Emerg Surg 2021 May 28. Epub 2021 May 28.

Division of Trauma Surgery, Department of Traumatology, University Hospital Zurich, University of Zurich, Raemistrasse 100, CH-8091, Zurich, Switzerland.

Introduction: There has been growing evidence in trauma literature that differences in insurance status lead to inequality in treatment and outcome. Most studies comparing uninsured to insured patients were done in the USA. We sought to gain further insights into differences in the outcomes of trauma patients in a healthcare system with mandatory public health coverage by comparing publicly versus privately insured patients. Read More

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Effect of the COVID-19 pandemic on health insurance coverage among trauma patients: a study of six level I trauma centers.

Trauma Surg Acute Care Open 2021 2;6(1):e000640. Epub 2021 Apr 2.

Trauma Research Department, Swedish Medical Center, Englewood, Colorado, USA.

Background: Increased unemployment during the COVID-19 pandemic has likely led to widespread loss of employer-provided health insurance. This study examined trends in health insurance coverage among trauma patients during the COVID-19 pandemic, including differences in demographics and clinical characteristics by insurance type.

Methods: This was a retrospective study on adult patients admitted to six level 1 trauma centers between January 1, 2018 and June 30, 2020. Read More

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The Challenges and Strategies of Affordable Care Act Navigators and In-Person Assisters with Enrolling Uninsured, Violently Injured Young Black Men into Healthcare Insurance Coverage.

Am J Mens Health 2021 Mar-Apr;15(2):15579883211005552

School of Medicine, University of Maryland Medical Center, Baltimore, MD, USA.

Low-income young Black men experience a disproportionate burden of violent injury in the United States. These men face significant disparities in healthcare insurance coverage and access to care. The Affordable Care Act (ACA) created a new healthcare workforce, Navigators and In-Person Assisters (IPAs), to support low-income minority populations with insurance enrollment. Read More

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ACQUISITION OF MEDICAID AT THE TIME OF INJURY: AN OPPORTUNITY FOR SUSTAINABLE INSURANCE COVERAGE.

J Trauma Acute Care Surg 2021 Mar 27. Epub 2021 Mar 27.

Department of Surgery, Stanford University School of Medicine, Stanford, CA Stanford-Surgery Policy Improvement Research and Education Center (S-SPIRE) Stanford University School of Medicine, Stanford, CA.

Introduction: Uninsured trauma patients are at higher risk of mortality, limited access to postdischarge resources and catastrophic health expenditure. Hospital Presumptive Eligibility (HPE), enacted with the 2014 Affordable Care Act, enables uninsured patients to be screened and acquired emergency Medicaid at the time of hospitalization. We sought to identify factors associated with successful acquisition of HPE insurance at the time of injury, hypothesizing that patients with higher injury severity (ISS>15) would be more likely to be approved for HPE. Read More

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Injured and broke: The impacts of the Ghana National Health Insurance Scheme (NHIS) on service delivery and catastrophic health expenditure among seriously injured children.

Afr J Emerg Med 2021 Mar 16;11(1):144-151. Epub 2020 Nov 16.

Department of Surgery, University of Washington, Seattle, WA, USA, Global Injury Control Section, Harborview Injury Prevention and Research Center.

Introduction: Ghana implemented a National Health Insurance Scheme (NHIS) in 2003 as a step toward universal health coverage. We aimed to determine the effect of the NHIS on timeliness of care, mortality, and catastrophic health expenditure (CHE) among children with serious injuries at a trauma center in Ghana.

Methods: We performed a retrospective cohort study of injured children aged <18 years who required surgery (i. Read More

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Insurance Status and Disparities in Outpatient Care after Traumatic Injuries of the Hand: A Retrospective Cohort Study.

Plast Reconstr Surg 2021 Mar;147(3):545-554

From the Division of Plastic and Reconstructive Surgery, Department of Surgery, Washington University School of Medicine in St. Louis; and the Department of Plastic and Reconstructive Surgery, The Ohio State University.

Background: Hand-injured patients seen in the emergency department can often be followed as outpatients for definitive care and rehabilitation. Many face barriers to continuing care in the outpatient setting that impact quality of care delivery. The authors aimed to evaluate patterns of outpatient follow-up after initial emergency department evaluation of traumatic hand injuries, identify factors associated with poor follow-up, and suggest areas for improvement. Read More

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The Impact of the Affordable Care Act on Burn Outcomes.

J Burn Care Res 2021 02;42(1):63-66

Department of Trauma and Burns, John H. Stroger, Jr. Hospital of Cook County, Chicago, Illinois.

Uninsured and low socioeconomic status patients who suffer burn injuries have disproportionately worse morbidity and mortality. The Affordable Care Act was signed into law with the goal of increasing access to insurance, with Medicaid expansion in January 2014 having the largest impact. To analyze the population-level impact of the Affordable Care Act on burn outcomes, and investigate its impact on identified at-risk subgroups, a retrospective time series of patients was created using data from the Healthcare Cost and Utilization Project National Inpatient Sample database between 2011 and 2016. Read More

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February 2021

Association of Interfacility Transfer and Patient and Hospital Characteristics With Thumb Replantation After Traumatic Amputation.

JAMA Netw Open 2021 02 1;4(2):e2036297. Epub 2021 Feb 1.

Section of Plastic Surgery, Department of Surgery, Michigan Medicine, Ann Arbor.

Importance: Given that 40% of hand function is achieved with the thumb, replantation of traumatic thumb injuries is associated with substantial quality-of-life benefits. However, fewer replantations are being performed annually in the US, which has been associated with less surgical expertise and increased risk of future replantation failures. Thus, understanding how interfacility transfers and hospital characteristics are associated with outcomes warrants further investigation. Read More

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February 2021

Prospective Evaluation of Health Literacy and Its Impact on Outcomes in Emergency General Surgery.

J Surg Res 2021 May 21;261:343-350. Epub 2021 Jan 21.

Division of Trauma, Critical Care, Burns and Emergency Surgery, Department of Surgery, College of Medicine, University of Arizona, Tucson, Arizona. Electronic address:

Background: Health literacy (HL) is an important component of national health policy. The aim of our study was to assess the prevalence of low HL (LHL) and determine its impact on outcomes after emergency general surgery (EGS).

Methods: We performed a (2016-2017) prospective cohort analysis of adult EGS patients. Read More

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A national analysis of pediatric firearm violence and the effects of race and insurance status on risk of mortality.

Am J Surg 2021 Jan 6. Epub 2021 Jan 6.

University of California, Irvine, Department of Surgery, Division of Trauma, Burns and Surgical Critical Care, Orange, CA, USA. Electronic address:

Objectives: To perform a national analysis of pediatric firearm violence (PFV), hypothesizing that black and uninsured patients would have higher risk of mortality.

Methods: The Trauma Quality Improvement Program (2014-2016) was queried for PFV patients ≤16 years-old. Multivariable logistic regression models on all patients and a subset excluding severe brain injuries were performed. Read More

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January 2021

Race and Insurance Status are Associated With Different Management Strategies After Thoracic Trauma.

J Surg Res 2021 May 2;261:18-25. Epub 2021 Jan 2.

Department of Surgery, New York University School of Medicine, New York, New York.

Introduction: Health-care disparities based on race and socioeconomic status among trauma patients are well-documented. However, the influence of these factors on the management of rib fractures following thoracic trauma is unknown. The aim of this study is to describe the association of race and insurance status on management and outcomes in patients who sustain rib fractures. Read More

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National health insurance and surgical care for injured people, Ghana.

Bull World Health Organ 2020 Dec 28;98(12):869-877. Epub 2020 Sep 28.

Department of Surgery, University of Washington, Seattle, USA.

Objective: To determine the association between having government health insurance and the timeliness and outcome of care, and catastrophic health expenditure in injured patients requiring surgery at a tertiary hospital in Ghana.

Methods: We reviewed the medical records of injured patients who required surgery at Komfo Anokye Teaching Hospital in 2015-2016 and extracted data on sociodemographic and injury characteristics, outcomes and out-of-pocket payments. We defined catastrophic health expenditure as ≥ 10% of the ratio of patients' out-of-pocket payments to household annual income. Read More

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December 2020

The Impact of the Affordable Care Act on Trauma Outcomes in At Risk Groups: An Interrupted Time Series Analysis with Control Group.

Ann Surg 2020 Nov 17. Epub 2020 Nov 17.

Department of Trauma and Burns John H. Stroger, Jr. Hospital of Cook County.

Objective: Analyze the impact of the ACA on trauma outcomes at a population level and within at-risk subgroups.

Background: Trauma disproportionately affects the uninsured. Compared to the insured, uninsured patients have worse functional outcomes and increased mortality. Read More

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November 2020

Predictors for 30-Day Readmissions After Traumatic Brain Injury.

J Head Trauma Rehabil 2021 May-Jun 01;36(3):E178-E185

Baylor Scott and White Institute for Rehabilitation, Dallas, Texas (Dr Pollifrone, Hamilton, and Dubiel); Baylor Scott and White Research Institute (Ms Callender and Dr Bennett), Dallas, Texas; Sports Therapy and Research, Baylor Scott and White Research, Frisco, Texas (Dr Driver); and Department of General Surgery, Baylor Scott and White University Medical Center, Dallas, Texas (Dr Petrey).

Objective: To examine predictors for 30-day readmission post-onset of traumatic brain injury (TBI) after initial trauma hospitalization.

Design: Retrospective cohort.

Participants: In total, 5284 patients with an acute TBI admitted from January 1, 2006, through December 31, 2015. Read More

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November 2020

Demographic trends of open globe injuries in a large inpatient sample.

Eye (Lond) 2020 Nov 1. Epub 2020 Nov 1.

Institute of Ophthalmology and Visual Science, Rutgers-New Jersey Medical School, Rutgers University, Newark, NJ, USA.

Purpose: To evaluate demographic trends of open globe injuries (OGIs) using a large dataset representative of United States population.

Methods: Retrospective cross-sectional observational study using the National Inpatient Sample (NIS) database from 2002 to 2013. Only patients with a primary admitting diagnosis of OGI were included. Read More

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November 2020

: a qualitative study on the perceptions of recovery following traumatic brain injury among Spanish-speaking U.S. immigrants.

Disabil Rehabil 2020 Oct 27:1-10. Epub 2020 Oct 27.

TIRR Memorial Hermann Brain Injury Research Center, Houston, TX, USA.

Purpose: To explore the impact of traumatic brain injury (TBI) on the quality of life (QoL) and self-concept of Spanish-speaking U.S. Hispanic immigrants with TBI. Read More

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October 2020

Clinician's guide for the management and research of osteoporosis in North African men: a guidelines comparison, a cost-effectiveness analysis, and a local algorithm.

Arch Osteoporos 2020 10 9;15(1):159. Epub 2020 Oct 9.

Department of Orthopaedics and Trauma Surgery, Basel University Hospital, Basel, Switzerland.

A local management algorithm and practice recommendations for the management of osteoporosis in Egyptian males were developed after assessing the applicability of current international recommendations and the cost effectiveness of local drugs. A systematic review and sensitivity analyses augmented the quality of the research efforts.

Purpose: Osteoporosis affects both men and women; however, no local recommendations for the condition are available for the male population. Read More

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October 2020

Insurance Type and Surgical-Patient Characteristics in the UPR-Affiliated Hospitals.

P R Health Sci J 2020 09;39(3):270-274

Department of Surgery, School of Medicine, University of Puerto Rico Medical Sciences Campus, San Juan, Puerto Rico.

Objective: The characteristics of surgical patients were examined according to type of health insurance to determine whether differences existed between these groups.

Methods: We evaluated the characteristics of cases in the UPR General Surgery Department's database (entered from January 1, 2018 through December 31, 2018) by insurance type. The variables examined included age, gender, inpatient/outpatient status, wound classification, type of surgery, American Society of Anesthesiology (ASA) scores and whether a given patient had diabetes, was a smoker, or suffered from hypertension. Read More

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September 2020

Healthcare utilisation and expenditure patterns for cardio-metabolic diseases in South Asian cities: the CARRS Study.

BMJ Open 2020 09 30;10(9):e036317. Epub 2020 Sep 30.

Hubert Department of Global Health, Emory University, Atlanta, Georgia, USA.

Objective: To estimate average annual expenditures per person, total economic burden and distress health financing associated with the treatment of five cardio-metabolic diseases (CMDs-hypertension, diabetes, heart disease (angina, myocardial infarction and heart failure), stroke and chronic kidney disease) in three metropolitan cities in South Asia.

Design: Cross-sectional surveys.

Setting: We analysed community-based baseline data from the Centre for cArdio-metabolic Risk Reduction in South Asia (CARRS) Study collected in 2010-2011 representing Chennai and New Delhi (India), and Karachi (Pakistan). Read More

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September 2020

Fate of the Uninsured Ankle Fracture: Significant Delays in Treatment Result in an Increased Risk of Surgical Site Infection.

J Orthop Trauma 2021 03;35(3):154-159

Department of Orthopaedics, UT Health San Antonio, San Antonio, TX; and.

Objective: To examine the impact of insurance status on access to orthopaedic care and incidence of surgical site complications in patients with closed unstable ankle fractures.

Design: Retrospective chart review.

Setting: Certified Level-1 urban trauma center and county facility. Read More

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Trauma patients returning to the emergency department after discharge.

Am J Surg 2020 12 29;220(6):1492-1497. Epub 2020 Aug 29.

Department of Surgery, Los Angeles County Harbor-UCLA Medical Center, Torrance, CA, USA.

Background: While readmission rates of trauma patients are well described, little has been reported on rates of re-presentation to the emergency department (ED) after discharge. This study aimed to determine rates and contributing factors of re-presentation of trauma patients to the ED.

Methods: One-year retrospective analysis of discharged adult trauma patients at a county-funded safety-net level one trauma center. Read More

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December 2020

The Affordable Care Act and emergency department use by low acuity patients in a US hospital.

Health Serv Manage Res 2020 Sep 3:951484820943599. Epub 2020 Sep 3.

University of Michigan Medical School, Ann Arbor, MI, USA.

Background: The Affordable Care Act (ACA) is one of the biggest healthcare reforms in US history. A key issue is the ACAs effect on low acuity, potentially primary care patients. This study evaluates the effect of the ACA on low acuity patients seen in the emergency department (ED). Read More

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September 2020

[Prevalence of People without Health Insurance and Interventions of Hospital Social Work at the University Hospital of Essen].

Gesundheitswesen 2020 Dec 31;82(12):955-960. Epub 2020 Aug 31.

Institut für Medizinische Informatik, Biometrie und Epidemiologie, Universitätsklinikum Essen, Essen.

Objective: In Germany, a number of people remain without health insurance, thus unable to access the formal health care sector. Reliable statistics covering the prevalence and description of uninsured patients, especially in the inpatient health care sector, are still lacking. Our study therefore aimed to assess the prevalence of uninsured patients at University Hospital of Essen over a period of five years. Read More

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December 2020

A National Analysis of Traumatic Thoracic Aortic Repair: Does Insurance Status Matter?

Am Surg 2020 Nov 27;86(11):1543-1547. Epub 2020 Jul 27.

Department of Surgery, Kendall Regional Medical Center, Miami, FL, USA.

Background: Traumatic thoracic aortic injuries (TAIs) carry a substantial mortality. Our study aim was to evaluate the impact of insurance status on outcomes in severely injured trauma patients after either thoracic endovascular aortic repair (TEVAR) or open repair using the National Trauma Data Bank Research Data Set (NTDB-RDS).

Methods: The NTDB-RDS was reviewed for outcomes in severely injured patients and TAI repair method (TEVAR vs open). Read More

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November 2020

Prescription opioid use and associated factors among US construction workers.

Am J Ind Med 2020 10 16;63(10):868-877. Epub 2020 Jul 16.

CPWR-The Center for Construction Research and Training, Silver Spring, Maryland.

Background: Construction workers are among the segments of the US population that were hit hardest by the opioid prescription and overdose deaths in the past decades. Factors that underlie opioid use in construction workers have been compartmentalized and isolated in existing studies of opioid use and opioid overdose, but they ignore the overall context of their use. This study examines prescription opioid use and its association with a variety of occupational and nonoccupational factors in construction workers in the United States. Read More

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October 2020

The Impact of the ACA on Burn Outcomes.

J Burn Care Res 2020 Jul 9. Epub 2020 Jul 9.

Department of Trauma and Burns John H. Stroger, Jr. Hospital of Cook County.

Uninsured and low socioeconomic status patients who suffer burn injuries have disproportionately worse morbidity and mortality. The Affordable Care Act was signed into law with the goal of increasing access to insurance, with Medicaid expansion in January 2014 having the largest impact. To analyze the population level impact of the Affordable Care Act on burn outcomes, and investigate its impact on identified at-risk subgroups, a retrospective time series of patients was created using data from the Healthcare Cost and Utilization Project National Inpatient Sample database between 2011 and 2016. Read More

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