Trauma Outcome Depends on Race and Insurance Status

Worse outcomes for blacks, Hispanics and uninsured patients

MONDAY, Oct. 20 (HealthDay News) -- Both race and insurance status are independent predictors of trauma mortality, according to the results of a study published in the October issue of the Archives of Surgery.

Adil H. Haider, M.D., of the Johns Hopkins University School of Medicine in Baltimore, and colleagues analyzed data from the National Trauma Data Bank on 429,751 trauma patients aged 18 to 64 years who had an Injury Severity Score of nine or more, of whom 72,249 were black, 41,770 were Hispanic and 262,878 were white. The Hispanic and black patients were more likely than their white counterparts to be uninsured and were more likely to have sustained penetrating trauma.

Crude mortality rates were lower among the 47 percent of patients who were insured, at 4.4 percent versus 8.6 percent for those uninsured, the authors write. Insured blacks and Hispanics also had higher mortality rates than insured whites, the data revealed. Uninsured black and Hispanic patients were 1.78 times and 2.30 times, respectively, more likely to die as a result of trauma than insured whites, the researchers found.

"This study refutes the notion that racial disparities are merely a reflection of insurance status differences," the authors conclude. "Understanding insurance and race-dependent differences is a crucial first step toward ameliorating health care disparities."

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