TY - JOUR
T1 - The effect of payer status on utilization of hospital resources in trauma care
AU - Rhee, Peter M.
AU - Grossman, David
AU - Rivara, Frederick
AU - Mock, Charles
AU - Jurkovich, Gregory
AU - Maier, Ronald V.
PY - 1997
Y1 - 1997
N2 - Objective: To determine the effect of payer status on outcome and resource utilization in motor vehicle-related trauma patients. Design: Retrospective cohort analysis that assessed the effect of payer status on outcome and resource utilization. Setting: The single level I trauma center in a regionalized statewide system. Patients: Consecutive patients (N=3141) who were hospitalized after a motor vehicle crash during a 3-year period. Main Outcome Measures: The mortality rate, disposition, total hospital length of stay (LOS), total intensive care unit LOS, and total hospital charges were examined for 2 categories of payers: 'commercial insurance' (commercial, labor and industry, and contract pay) anti 'noncommercial insurance' (Medicaid and self-pay). Results: After controlling far age, sex, race, and the Injury Severity Score, the payer status had no overall effect on the mortality rate, disposition, total hospital charges, total hospital LOS, or total intensive care unit LOS. However, there was a significantly (11.4%; P<.05) longer LOS for those patients with noncommercial insurance who required transfer to another facility for rehabilitation or long-term care. Conclusions: The utilization of hospital trauma care resources in a level I facility in a regionalized system was not associated with insurance status. Patients with noncommercial insurance who required transfer to elective long- term care facilities had a longer LOS due to delays in obtaining subsequent access. Health care policy should provide appropriate reimbursement for all aspects of regionalized trauma care systems to ensure maintenance of an egalitarian approach to care.
AB - Objective: To determine the effect of payer status on outcome and resource utilization in motor vehicle-related trauma patients. Design: Retrospective cohort analysis that assessed the effect of payer status on outcome and resource utilization. Setting: The single level I trauma center in a regionalized statewide system. Patients: Consecutive patients (N=3141) who were hospitalized after a motor vehicle crash during a 3-year period. Main Outcome Measures: The mortality rate, disposition, total hospital length of stay (LOS), total intensive care unit LOS, and total hospital charges were examined for 2 categories of payers: 'commercial insurance' (commercial, labor and industry, and contract pay) anti 'noncommercial insurance' (Medicaid and self-pay). Results: After controlling far age, sex, race, and the Injury Severity Score, the payer status had no overall effect on the mortality rate, disposition, total hospital charges, total hospital LOS, or total intensive care unit LOS. However, there was a significantly (11.4%; P<.05) longer LOS for those patients with noncommercial insurance who required transfer to another facility for rehabilitation or long-term care. Conclusions: The utilization of hospital trauma care resources in a level I facility in a regionalized system was not associated with insurance status. Patients with noncommercial insurance who required transfer to elective long- term care facilities had a longer LOS due to delays in obtaining subsequent access. Health care policy should provide appropriate reimbursement for all aspects of regionalized trauma care systems to ensure maintenance of an egalitarian approach to care.
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U2 - 10.1001/archsurg.1997.01430280073010
DO - 10.1001/archsurg.1997.01430280073010
M3 - Article
C2 - 9108761
AN - SCOPUS:0030901618
SN - 2168-6254
VL - 132
SP - 399
EP - 404
JO - JAMA Surgery
JF - JAMA Surgery
IS - 4
ER -