Research Conducted at Hennepin Healthcare Has Updated Our Knowledge about Managed Care (Firearm Trauma: Race and Insurance Influence Mortality and Discharge Disposition): Managed Care

Health Policy and Law Daily

2022 JUN 28 (NewsRx) -- By a News Reporter-Staff News Editor at Health Policy and Law Daily -- Fresh data on Managed Care are presented in a new report. According to news reporting originating from Minneapolis, Minnesota, by NewsRx correspondents, research stated, “Health insurance and race impact mortality and discharge outcomes in the general trauma population. It remains unclear if disparities exist by race and/or insurance in outcomes following firearm injuries.”

Financial supporters for this research include Hitchcock Surgical Society Resident Research Fund, National Institutes of Health’s National Center for Advancing Translational Sciences.

Our news editors obtained a quote from the research from Hennepin Healthcare, “The purpose of this study was to assess differences in mortality and discharge based on race and insurance status following firearm injuries. The National Trauma Data Bank (2007-2016) was queried for firearm injuries by International Classification of Diseases, Ninth/Tenth Revision, Ecodes. Patients with known discharge disposition, age (18-64 years), race, and insurance were included in analysis (N = 120,005). To minimize bias due to missing data, we used multiple imputation for variables associated with outcomes following traumatic injury: Injury Severity Score, Glasgow Coma Scale score, respiratory rate, systolic blood pressure, and sex. Multivariable regression analysis was additionally adjusted for age, sex, Injury Severity Score, intent, Glasgow Coma Scale score, systolic blood pressure, heart rate, respiratory rate, year, and clustered by facility to assess differences in mortality and discharge disposition. The average age was 31 years, 88.6% were male, and 50% non-Hispanic Blacks. Overall mortality was 11.5%. Self-pay insurance was associated with a significant increase in mortality rates in all racial groups compared with non-Hispanic Whites with commercial insurance. Hispanic commercial, Medicaid, and self-pay patients were significantly less likely to discharge with posthospital care compared with commercially insured non-Hispanic Whites. When examining racial differences in mortality and discharge by individual insurance types, commercially insured non-Hispanic Black and other race patients were significantly less likely to die compared with similarly insured non-Hispanic White patients. Regardless of race, no significant differences in mortality were observed in Medicaid or self-pay patients compared with non-Hispanic White patients. Victims of firearm injuries with a self-pay insurance status have a significantly higher rate of mortality. Hispanic patients regardless of insurance status were significantly less likely to discharge with posthospital care compared with non-Hispanic Whites with commercial insurance.”

According to the news editors, the research concluded: “Continued efforts are needed to understand and address the relationship between insurance status, race, and outcomes following firearm violence.”

This research has been peer-reviewed.

For more information on this research see: Firearm Trauma: Race and Insurance Influence Mortality and Discharge Disposition. Journal of Trauma and Acute Care Surgery, 2022;92(6):1005-1011. Journal of Trauma and Acute Care Surgery can be contacted at: Lippincott Williams & Wilkins, Two Commerce Sq, 2001 Market St, Philadelphia, PA 19103, USA. (Lippincott Williams and Wilkins - www.lww.com; Journal of Trauma and Acute Care Surgery - http://journals.lww.com/jtrauma/pages/default.aspx)

The news editors report that additional information may be obtained by contacting Rachel M. Nygaard, Hennepin Healthcare, Dept. of Surgery, 701 Pk Ave S, P5, Minneapolis, MN 55415, United States. Additional authors for this research include Derek C. Lumbard, Ashley P. Marek, Frederick W. Endorf, Chad J. Richardson and Rebecca L. Freese.

The direct object identifier (DOI) for that additional information is: https://doi.org/10.1097/TA.0000000000003512. This DOI is a link to an online electronic document that is either free or for purchase, and can be your direct source for a journal article and its citation.

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