Socioeconomic Status and Outcomes After Burn Injury

The objective of this article is to explore the impact of socioeconomic status on outcome metrics in post-burn injury patients. Retrospective review of patients with TBSA >15% between 2005 and 2012. Demographics and clinical course were recorded. Socioeconomics were approximated using census data of percent below poverty level at patient zip code, which was also used for calculating distance to regional burn center. Statistical analysis was performed using Statistical Analysis Software. Odds ratios and 95% confidence intervals were calculated followed by regression models for factors associated with graft loss and readmission. Two hundred and fifty subjects survived to discharge: 33% were of upper socioeconomic status, 32% were of middle status, and 35% were of lower status. Fourteen percentage of patients lived <99 miles from the burn center, 60% 100 to 249 miles away, and 26% >240 miles away. Eighty readmissions occurred among 39 patients; 43% were unplanned. Each percent increase in TBSA was associated with a 5% increase in likelihood of being readmitted. Thirty six percentage of readmission patients were covered under worker's compensation. Patients with worker's compensation were four times more likely to be readmitted than private insurance. Only worker's compensation had a majority of unplanned readmissions (58%). Graft loss occurred in 12% of patients. Those in the low socioeconomic group had five times the odds of having graft loss than those in the high socioeconomics. There was no correlation between graft loss and insurance status or distance. Findings indicate strong and statistically significant correlations between type of insurance and likelihood of readmission and between graft loss and poverty.