Insurance Does Not Affect Adverse Events While Awaiting Surgery for Ankle Trauma in One System.
Insurance Does Not Affect Adverse Events While Awaiting Surgery for Ankle Trauma in One System.
- 2020
CONCLUSION: The sampled facilities did not have adverse event rates that differed based on insurance status or demographic features. These facilities, with hospital-based subsidy programs and higher than expected admission rates, may manage their vulnerable populations well and may indicate their efforts to eliminate health disparity are effective. INTRODUCTION: Ankle injuries that are not properly cared for can have devastating effects on a patient's health and ability to maintain an active lifestyle. Recommended outpatient surgery may be difficult to obtain for many groups of patients, including those without insurance or minority races. Patients who are of low socioeconomic status also have worse outcomes following trauma. The purpose of this study was to examine whether insurance status impacts the number of adverse events that patients face prior to receiving surgical treatment following an emergency department (ED) visit for an acute ankle injury. METHODS: We conducted a retrospective chart review at two medical centers within the same healthcare system. The sample included 192 patients presenting to the ED with an unstable ankle injury between October 1, 2015- May 1, 2018. We used chi-square and t-test analysis to determine differences in rates of adverse events occurring while awaiting surgery. RESULTS: Few (4%) patients presented as being self-pay. Neither Medicare (chi2 (1) (N = 192) = 2.389, p = .122), Medicaid (chi2 (1), (N = 192) = .084, p = .772), other insurances (chi2 (1) (N = 192) = .567, p = .452), or private insurance (chi2 (1) (N=192) = .000, p = .982) was associated with a difference in rates of adverse events. Likewise, gender (chi2 (1) (N = 192) = .402, p = .526), race (chi2 (3) (N = 192) = 2.504, p = .475), and all other demographic variables failed to show a difference in occurrence of adverse events. Those admitted to the hospital did show a lower rate of adverse events compared to those sent home from the ED (chi2 (1) (N = 192) = 5.452, p = .020). Sampled patients were admitted to the hospital at a high rate (49%).
English
1936-900X
10.5811/westjem.2020.5.46861 [doi] PMC7514388 [pmc] westjem.2020.5.46861 [pii]
*Ankle Injuries/su [Surgery]
*Hospitalization
*Insurance Coverage
Adult
Ambulatory Surgical Procedures/ec [Economics]
Ambulatory Surgical Procedures/mt [Methods]
Ankle Injuries/ec [Economics]
Ankle Injuries/ep [Epidemiology]
Female
Healthcare Disparities
Hospitalization/ec [Economics]
Hospitalization/sn [Statistics & Numerical Data]
Humans
Male
Medicaid/sn [Statistics & Numerical Data]
Medicare/sn [Statistics & Numerical Data]
Outcome and Process Assessment, Health Care
Retrospective Studies
Socioeconomic Factors
United States/ep [Epidemiology]
Washington Cancer Institute
Journal Article
CONCLUSION: The sampled facilities did not have adverse event rates that differed based on insurance status or demographic features. These facilities, with hospital-based subsidy programs and higher than expected admission rates, may manage their vulnerable populations well and may indicate their efforts to eliminate health disparity are effective. INTRODUCTION: Ankle injuries that are not properly cared for can have devastating effects on a patient's health and ability to maintain an active lifestyle. Recommended outpatient surgery may be difficult to obtain for many groups of patients, including those without insurance or minority races. Patients who are of low socioeconomic status also have worse outcomes following trauma. The purpose of this study was to examine whether insurance status impacts the number of adverse events that patients face prior to receiving surgical treatment following an emergency department (ED) visit for an acute ankle injury. METHODS: We conducted a retrospective chart review at two medical centers within the same healthcare system. The sample included 192 patients presenting to the ED with an unstable ankle injury between October 1, 2015- May 1, 2018. We used chi-square and t-test analysis to determine differences in rates of adverse events occurring while awaiting surgery. RESULTS: Few (4%) patients presented as being self-pay. Neither Medicare (chi2 (1) (N = 192) = 2.389, p = .122), Medicaid (chi2 (1), (N = 192) = .084, p = .772), other insurances (chi2 (1) (N = 192) = .567, p = .452), or private insurance (chi2 (1) (N=192) = .000, p = .982) was associated with a difference in rates of adverse events. Likewise, gender (chi2 (1) (N = 192) = .402, p = .526), race (chi2 (3) (N = 192) = 2.504, p = .475), and all other demographic variables failed to show a difference in occurrence of adverse events. Those admitted to the hospital did show a lower rate of adverse events compared to those sent home from the ED (chi2 (1) (N = 192) = 5.452, p = .020). Sampled patients were admitted to the hospital at a high rate (49%).
English
1936-900X
10.5811/westjem.2020.5.46861 [doi] PMC7514388 [pmc] westjem.2020.5.46861 [pii]
*Ankle Injuries/su [Surgery]
*Hospitalization
*Insurance Coverage
Adult
Ambulatory Surgical Procedures/ec [Economics]
Ambulatory Surgical Procedures/mt [Methods]
Ankle Injuries/ec [Economics]
Ankle Injuries/ep [Epidemiology]
Female
Healthcare Disparities
Hospitalization/ec [Economics]
Hospitalization/sn [Statistics & Numerical Data]
Humans
Male
Medicaid/sn [Statistics & Numerical Data]
Medicare/sn [Statistics & Numerical Data]
Outcome and Process Assessment, Health Care
Retrospective Studies
Socioeconomic Factors
United States/ep [Epidemiology]
Washington Cancer Institute
Journal Article