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A Retrospective Cohort Study on Health Insurance: Related Disparities in Trauma Patients After Penetrating Injuries:
Rafael De Ayala-Hillman1, Cristina Diaz-Marty2, Ediel Ramos-Meléndez3
1Department of Surgery, School of Medicine, Medical Sciences Campus, University of Puerto Rico, San Juan, Puerto Rico.
Puerto Rico Health Sciences Journal
|November 18, 2021
Summary
Uninsured patients with gunshot wounds faced a higher risk of death in trauma care. Health insurance may reduce mortality risk in trauma settings, highlighting the need for equitable healthcare access.
Area of Science:
- Trauma Surgery
- Health Services Research
- Public Health
Background:
- The link between health insurance and outcomes is understudied in trauma patients.
- Healthcare systems in Puerto Rico differ from the United States.
- Assessing mortality disparities related to insurance coverage is crucial.
Purpose of the Study:
- To evaluate mortality disparities based on insurance coverage at the Puerto Rico Trauma Hospital (PRTH).
- To investigate the association between insurance status and mortality risk in trauma patients.
Main Methods:
- Retrospective cohort study of patients with penetrating injuries at PRTH (2000-2014).
- Classification of patients by insurance status (public, private, uninsured).
- Logistic regression analysis to determine the association between insurance status and mortality.
Main Results:
- Patients with public insurance had more complications, longer mechanical ventilation, and longer hospital stays.
- Uninsured patients with gunshot wounds showed a 54% increased likelihood of death compared to those with private insurance.
- Private health insurance (PrHI) was associated with lower mortality risk compared to being uninsured.
Conclusions:
- Health insurance may be a protective factor against mortality in trauma patients.
- Equitable access to health services could prevent premature deaths in trauma populations.
- Further research with larger sample sizes is recommended to confirm these findings.
