FRIDAY, Feb. 21, 2014 (HealthDay News) -- For patients with severe injuries initially evaluated at a non-trauma center emergency department, admission versus transfer to a trauma center is more likely for patients with Medicaid or private insurance, compared with no insurance, according to a study published online Feb. 19 in JAMA Surgery.
M. Kit Delgado, M.D., from the University of Pennsylvania in Philadelphia, and colleagues conducted a retrospective analysis of the 2009 Nationwide Emergency Department Sample. The authors sought to determine patient- and hospital-level factors associated with the decision to admit rather than transfer severely injured patients from non-trauma center emergency departments to trauma centers.
The researchers identified 4,513 observations from 636 non-trauma center emergency departments in 2009, representing a nationally weighted population of 19,312 non-trauma center emergency department encounters for major trauma. In 2009, 54.5 percent were admitted to the non-trauma center. The adjusted absolute risk of admission versus transfer was 14.3 percent higher for patients with Medicaid and 11.2 percent higher for patients with private insurance, compared with patients without insurance. Severe abdominal injuries, urban teaching hospital versus non-teaching hospital, and annual emergency department visit volume were also associated with admission versus transfer.
"Given that transfer to a trauma center has been shown to reduce mortality, these insured patients may be receiving suboptimal care," the authors write.
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