Insurance Does Not Affect Adverse Events While Awaiting Surgery for Ankle Trauma in One System

Area of Science:

• Orthopedics
• Health Services Research
• Public Health

Background:

• Ankle injuries can severely impact patient health and activity levels.
• Access to recommended outpatient surgery is a challenge for uninsured, minority, and low socioeconomic status patients.
• Poorer outcomes are observed in patients of lower socioeconomic status following trauma.

Purpose of the Study:

• To investigate the impact of insurance status on adverse events in patients with acute ankle injuries.
• To analyze pre-surgical adverse events following an emergency department visit for ankle trauma.
• To identify potential disparities in care related to socioeconomic factors.

Main Methods:

• Retrospective chart review of 192 patients with unstable ankle injuries treated between October 2015 and May 2018.
• Analysis of adverse events occurring while awaiting surgery.
• Chi-square and t-test analyses to compare adverse event rates across different insurance statuses and demographic groups.

Main Results:

• No significant difference in adverse event rates was found based on insurance status (Medicare, Medicaid, private, self-pay) or demographics (gender, race).
• Patients admitted to the hospital had a significantly lower rate of adverse events compared to those discharged from the emergency department (p = .020).
• A high admission rate (49%) was observed in the sampled patient population.

Conclusions:

• The studied facilities demonstrated no disparity in adverse event rates related to insurance or demographics.
• Hospital-based subsidy programs and high admission rates may contribute to effective management of vulnerable patient populations.
• These findings suggest successful efforts in mitigating health disparities at the examined healthcare facilities.