Association of health insurance coverage and probability of dying in an emergency department or hospital from a motor vehicle traffic injury

Journal of the American College of Emergency Physicians Open

Alec W. Becker¹  Lindsay Shea²  Jim P. Stimpson²  Fernando A. Wilson³ 

[1] Drexel University, A.J. Drexel Autism Institute Philadelphia Pennsylvania USA;Drexel University, Dornsife School of Public Health Philadelphia Pennsylvania USA;University of Utah, Matheson Center for Health Care Studies Salt Lake City Utah USA;

关键词: emergency care;    emergency medicine;    health insurance;    mortality;    motor vehicle;    uninsured;   

DOI  :  10.1002/emp2.12652

来源: DOAJ

【 摘 要 】

Abstract Objective Describe the association of health insurance coverage with the odds of mortality in an emergency department (ED) or hospital for adult victims of a motor vehicle crash. Methods This cross‐sectional study pooled and averaged 6 years of data, 2009–2014, from the Nationwide Emergency Department Sample (NEDS). Our analysis was restricted to patients 20–85 years old that were treated in an ED for an injury sustained from a motor vehicle traffic crash (N = 2,203,407 average annual hospital discharges). The outcome variables were whether the motor vehicle crash victim died in the ED or hospital. The predictor variable was health insurance status that was measured as uninsured, Medicare, Medicaid, private insurance, and other health insurance. Results Most patients that died had some form of health insurance with less than a quarter classified as uninsured (23%). Nearly half of the patients that died had private insurance (48%) followed by Medicare (13%), Medicaid (9%), and other insurance (8%). Compared to the uninsured, the multivariate adjusted odds ratios (ORs) for death were significantly (P < 0.001) lower for Medicare (OR = 0.83, 95% confidence interval [CI] = 0.76–0.92), Medicaid (OR = 0.76, 95% CI = 0.69–0.84), private insurance (OR = 0.63, 95% CI = 0.58–0.68), and other insurance (OR = O.61, 95% CI = 0.54–0.70). Conclusion After accounting for hospital and patient characteristics, lack of health insurance was associated with a higher likelihood of death for patients admitted to an ED or hospital for injuries sustained from a motor vehicle crash.

【 授权许可】

Unknown