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Inverse Probability of Treatment Weighting Propensity Score using the Military Health System Data Repository and National Death Index
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Disparities in Care Among Gunshot Victims: A Nationwide Analysis
Reynold Henry1, Panagiotis K Liasidis2, Blade Olson2
1Division of Trauma, Critical Care & Acute Care Surgery, Oregon Health & Science University, Portland, Oregon.
The Journal of Surgical Research
|November 13, 2022
Summary
Black patients with gunshot wounds face higher mortality rates and reduced ICU admissions compared to White patients. This study highlights critical racial disparities in trauma care outcomes and resource allocation in the US.
Area of Science:
- Trauma Surgery
- Health Services Research
- Health Equity
Background:
- Healthcare disparities disproportionately affect racial and ethnic minorities.
- In-hospital bias may influence care for underrepresented trauma patients.
- Examining racial differences in trauma care is crucial for addressing inequities.
Purpose of the Study:
- To investigate racial disparities in outcomes among U.S. gunshot wound victims.
- To analyze racial differences in resource utilization for trauma patients.
- To identify potential biases in trauma healthcare delivery.
Main Methods:
- Retrospective review of the National Trauma Data Bank (NTDB) from 2007-2017.
- Inclusion of patients with non-accidental, non-suicidal gunshot wounds.
- Stratification by race and analysis of mortality, ICU admission, and discharge disposition.
Main Results:
- Black patients exhibited higher mortality odds (OR 1.14) and lower ICU admission odds (OR 0.76) compared to White patients.
- Hispanic patients were less likely to be discharged to rehabilitation centers (OR 0.78).
- Black patients had the shortest median time to death (24 minutes).
Conclusions:
- Significant racial disparities exist in trauma care outcomes for gunshot wound victims.
- Higher mortality among Black patients warrants further investigation into causes and solutions.
- Healthcare institutions must address implicit bias to ensure equitable trauma care.
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