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Traumatic Brain Injury l: Introduction01:28

Traumatic Brain Injury l: Introduction

DefinitionTraumatic brain injury, or TBI, is a disturbance of normal brain function induced by an external mechanical force, such as a direct blow to the head or a penetrating injury. It can affect both brain structure and function, producing a wide range of clinical outcomes. TBI is a heterogeneous condition, meaning its effects may differ based on the type, location, and severity of the injury.Basis of ClassificationTBI is classified based on severity, injury mechanism, or pathophysiology. In...

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Association Between Health Insurance and Outcomes After Traumatic Brain Injury: A National ACS-TQP-PUF Database

Kevin E Galicia1, Sarah D Haider2, Lauren E Reidy2

  • 1Department of Surgery, Loyola University Medical Center, Maywood, Illinois; Burn and Shock Trauma Research Institute, Stritch School of Medicine, Loyola University Chicago Health Sciences Division, Maywood, Illinois.

The Journal of Surgical Research
|May 12, 2023
PubMed
Summary
This summary is machine-generated.

Uninsured patients with traumatic brain injury (TBI) face higher mortality and worse outcomes. Lack of health insurance is linked to increased in-hospital deaths and reduced facility discharge, despite shorter hospital stays.

Keywords:
Brain injuriesHealth care disparitiesInsurance statusTBI mortalityTBI outcomesTraumatic brain injury outcomes

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Area of Science:

  • Trauma care
  • Health services research
  • Neurology

Background:

  • Health insurance status significantly impacts patient outcomes across various medical conditions.
  • The specific influence of insurance on outcomes following isolated traumatic brain injury (TBI) is not well-established.
  • Approximately 8.6% of the US population lacks health insurance, highlighting the relevance of this issue.

Purpose of the Study:

  • To investigate the association between health insurance status and outcomes in patients with isolated traumatic brain injury (TBI).
  • To determine if insurance status independently affects mortality, length of stay, and discharge disposition after TBI.

Main Methods:

  • Utilized data from the Trauma Quality Programs Participant Use Files (2017-2019).
  • Identified patients with isolated TBI (Head AIS > 3, other AIS < 3), excluding specific criteria like DOA or Head AIS=6.
  • Employed multivariate regression analyses to assess the relationship between insurance status and key TBI outcomes.

Main Results:

  • Out of 199,556 TBI patients, 9.5% were uninsured; uninsured patients were younger, more often male, less comorbid, and less severely injured.
  • Uninsured patients had higher unadjusted and adjusted in-hospital mortality rates (OR 1.62, P < 0.001).
  • Lack of insurance was associated with decreased likelihood of discharge to a facility (OR 0.38) and reduced ICU/hospital LOS (Coeff. -0.61 to -0.82).

Conclusions:

  • Insurance status is an independent predictor of outcome disparities in isolated TBI.
  • Despite healthcare reforms, uninsured individuals with TBI experience worse outcomes, including increased mortality and reduced facility discharge.
  • Findings underscore the persistent impact of insurance on TBI patient trajectories and care access.