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Racial and Demographic Differences in Use of a Trauma Center Confidential Status Policy
Drew J Wodecki1, Ilana Osowiecki2, Christy Adams3
1Department of Internal Medicine, University of Virginia, Charlottesville, Virginia, USA.
Summary
Hospital confidential status policies for trauma patients disproportionately affect Black and Latine individuals. Staff concerns highlight potential negative impacts on patient care and family experiences, suggesting policy ineffectiveness.
Area of Science:
- Trauma care
- Health policy
- Health equity
Background:
- Confidential status restricts visitor access for trauma patients, aiming to enhance safety.
- This practice may lead to unintended negative consequences for patients and staff.
Purpose of the Study:
- To examine racial/ethnic disparities in the application of confidential status in a trauma center.
- To assess healthcare staff's knowledge and perceptions of the confidential status policy and its impact on patient care.
Main Methods:
- A mixed-methods study combining retrospective cohort analysis (2015-2020) and qualitative data (surveys, interviews).
- Multivariable logistic regression analyzed associations between confidential status and patient characteristics.
- Surveys and interviews explored staff awareness and views on the policy's effects.
Main Results:
- Black and Latine patients were significantly more likely to be placed on confidential status compared to White patients.
- Only 38% of staff reported reading the policy; most perceived its impact on patient care as neutral.
- Qualitative themes included family trauma, discrimination, workplace stress, and policy ineffectiveness.
Conclusions:
- Racial and ethnic disparities exist in the implementation of confidential status.
- Staff perceptions indicate potential negative impacts on patients and families, questioning the policy's effectiveness and highlighting a need for review.
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