Patient and Hospital Characteristics Associated with Admission Among Patients With Minor Isolated Extremity Firearm Injuries: A Propensity-Matched Analysis

Objective:. To quantify the association between insurance and hospital admission following minor isolated extremity firearm injury. Background:. The association between insurance and injury admission has not been examined. Methods:. This was an observational retrospective cohort study of minor isola...

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Main Authors: Arielle C. Thomas, MD, MPH, MS, Regina Royan, MD, MPH, Avery B. Nathens, MD, PhD, Brendan T. Campbell, MD, MPH, Susheel Reddy, MPH, Sarabeth Spitzer, MD, Doulia Hamad, MD, Angie Jang, BA, Anne M. Stey, MD, MSc
Format: Article
Language:English
Published: Wolters Kluwer Health 2024-06-01
Series:Annals of Surgery Open
Online Access:http://journals.lww.com/10.1097/AS9.0000000000000430
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author Arielle C. Thomas, MD, MPH, MS
Regina Royan, MD, MPH
Avery B. Nathens, MD, PhD
Brendan T. Campbell, MD, MPH
Susheel Reddy, MPH
Sarabeth Spitzer, MD
Doulia Hamad, MD
Angie Jang, BA
Anne M. Stey, MD, MSc
author_facet Arielle C. Thomas, MD, MPH, MS
Regina Royan, MD, MPH
Avery B. Nathens, MD, PhD
Brendan T. Campbell, MD, MPH
Susheel Reddy, MPH
Sarabeth Spitzer, MD
Doulia Hamad, MD
Angie Jang, BA
Anne M. Stey, MD, MSc
author_sort Arielle C. Thomas, MD, MPH, MS
collection DOAJ
description Objective:. To quantify the association between insurance and hospital admission following minor isolated extremity firearm injury. Background:. The association between insurance and injury admission has not been examined. Methods:. This was an observational retrospective cohort study of minor isolated extremity firearm injury captured in the Healthcare Cost and Utilization Project State Inpatient and Emergency Department Databases in 6 states (New York, Arkansas, Wisconsin, Massachusetts, Florida, and Maryland) from 2016 to 2017 among patients aged 16 years or older. The primary exposure was insurance. Admitted patients were propensity score matched to nonadmitted patients on age, extremity Abbreviated Injury Score, and Elixhauser Comorbidity Index with exact matching within hospital to adjust for selection bias. A general estimating equation logistic regression estimated the association between insurance and odds of admission in the matched cohort while controlling for sex, race, injury intent, injury type, hospital profit type, and trauma center designation with observations clustered by propensity score-matched pairs within hospital. Results:. A total of 8151 patients presented to hospital with a minor isolated extremity firearm injury between 2016 and 2017 in 6 states. Patients were 88.0% male, 56.6% Black, and 71.7% aged 16 to 36 years old, and 22.1% were admitted. A total of 2090 patients were matched on propensity for admission. Privately insured matched patients had 1.70 higher adjusted odds of admission and 95% confidence interval of 1.30 to 2.22, compared with uninsured after adjusting for patient and hospital characteristics. Conclusions:. Insurance was associated with hospital admission for minor isolated extremity firearm injury.
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spelling doaj-art-4f47b90deeb64ec1950fb228e84ba79a2025-01-24T09:18:39ZengWolters Kluwer HealthAnnals of Surgery Open2691-35932024-06-0152e43010.1097/AS9.0000000000000430202406000-00028Patient and Hospital Characteristics Associated with Admission Among Patients With Minor Isolated Extremity Firearm Injuries: A Propensity-Matched AnalysisArielle C. Thomas, MD, MPH, MS0Regina Royan, MD, MPH1Avery B. Nathens, MD, PhD2Brendan T. Campbell, MD, MPH3Susheel Reddy, MPH4Sarabeth Spitzer, MD5Doulia Hamad, MD6Angie Jang, BA7Anne M. Stey, MD, MSc8From the * Department of Surgery, Medical College of Wisconsin, Milwaukee, WI‡ Department of Emergency Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL† American College of Surgeons, Chicago, IL‖ Department of Pediatric Surgery, Connecticut Children’s Medical Center and University of Connecticut School of Medicine, Hartford, CT¶ Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL# Department of Surgery, Center for Surgery and Public Health, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA§ Department of Surgery, Sunnybrook Health Sciences Center and the University of Toronto, Toronto, ON, Canada** Department of Surgery, Feinberg School of Medicine, Northwestern University, Chicago, IL.** Department of Surgery, Feinberg School of Medicine, Northwestern University, Chicago, IL.Objective:. To quantify the association between insurance and hospital admission following minor isolated extremity firearm injury. Background:. The association between insurance and injury admission has not been examined. Methods:. This was an observational retrospective cohort study of minor isolated extremity firearm injury captured in the Healthcare Cost and Utilization Project State Inpatient and Emergency Department Databases in 6 states (New York, Arkansas, Wisconsin, Massachusetts, Florida, and Maryland) from 2016 to 2017 among patients aged 16 years or older. The primary exposure was insurance. Admitted patients were propensity score matched to nonadmitted patients on age, extremity Abbreviated Injury Score, and Elixhauser Comorbidity Index with exact matching within hospital to adjust for selection bias. A general estimating equation logistic regression estimated the association between insurance and odds of admission in the matched cohort while controlling for sex, race, injury intent, injury type, hospital profit type, and trauma center designation with observations clustered by propensity score-matched pairs within hospital. Results:. A total of 8151 patients presented to hospital with a minor isolated extremity firearm injury between 2016 and 2017 in 6 states. Patients were 88.0% male, 56.6% Black, and 71.7% aged 16 to 36 years old, and 22.1% were admitted. A total of 2090 patients were matched on propensity for admission. Privately insured matched patients had 1.70 higher adjusted odds of admission and 95% confidence interval of 1.30 to 2.22, compared with uninsured after adjusting for patient and hospital characteristics. Conclusions:. Insurance was associated with hospital admission for minor isolated extremity firearm injury.http://journals.lww.com/10.1097/AS9.0000000000000430
spellingShingle Arielle C. Thomas, MD, MPH, MS
Regina Royan, MD, MPH
Avery B. Nathens, MD, PhD
Brendan T. Campbell, MD, MPH
Susheel Reddy, MPH
Sarabeth Spitzer, MD
Doulia Hamad, MD
Angie Jang, BA
Anne M. Stey, MD, MSc
Patient and Hospital Characteristics Associated with Admission Among Patients With Minor Isolated Extremity Firearm Injuries: A Propensity-Matched Analysis
Annals of Surgery Open
title Patient and Hospital Characteristics Associated with Admission Among Patients With Minor Isolated Extremity Firearm Injuries: A Propensity-Matched Analysis
title_full Patient and Hospital Characteristics Associated with Admission Among Patients With Minor Isolated Extremity Firearm Injuries: A Propensity-Matched Analysis
title_fullStr Patient and Hospital Characteristics Associated with Admission Among Patients With Minor Isolated Extremity Firearm Injuries: A Propensity-Matched Analysis
title_full_unstemmed Patient and Hospital Characteristics Associated with Admission Among Patients With Minor Isolated Extremity Firearm Injuries: A Propensity-Matched Analysis
title_short Patient and Hospital Characteristics Associated with Admission Among Patients With Minor Isolated Extremity Firearm Injuries: A Propensity-Matched Analysis
title_sort patient and hospital characteristics associated with admission among patients with minor isolated extremity firearm injuries a propensity matched analysis
url http://journals.lww.com/10.1097/AS9.0000000000000430
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