Open AccessAssociation of health insurance coverage and probability of dying in an emergency department or hospital from a motor vehicle traffic injury
Author(s) -
Stimpson Jim P.,
Becker Alec W.,
Shea Lindsay,
Wilson Fernando A.
Publication year - 2022
Publication title -
journal of the american college of emergency physicians open
Language(s) - English
Resource type - Journals
ISSN - 2688-1152
DOI - 10.1002/emp2.12652
Subject(s) - medicaid , medicine , emergency department , odds ratio , confidence interval , emergency medicine , odds , occupational safety and health , health insurance , injury prevention , crash , poison control , demography , medical emergency , health care , logistic regression , psychiatry , sociology , computer science , economics , programming language , economic growth , pathology
Objective Describe the association of health insurance coverage with the odds of mortality in an emergency department (ED) or hospital for adult victims of a motor vehicle crash. Methods This cross‐sectional study pooled and averaged 6 years of data, 2009–2014, from the Nationwide Emergency Department Sample (NEDS). Our analysis was restricted to patients 20–85 years old that were treated in an ED for an injury sustained from a motor vehicle traffic crash (N = 2,203,407 average annual hospital discharges). The outcome variables were whether the motor vehicle crash victim died in the ED or hospital. The predictor variable was health insurance status that was measured as uninsured, Medicare, Medicaid, private insurance, and other health insurance. Results Most patients that died had some form of health insurance with less than a quarter classified as uninsured (23%). Nearly half of the patients that died had private insurance (48%) followed by Medicare (13%), Medicaid (9%), and other insurance (8%). Compared to the uninsured, the multivariate adjusted odds ratios (ORs) for death were significantly ( P < 0.001) lower for Medicare (OR = 0.83, 95% confidence interval [CI] = 0.76–0.92), Medicaid (OR = 0.76, 95% CI = 0.69–0.84), private insurance (OR = 0.63, 95% CI = 0.58–0.68), and other insurance (OR = O.61, 95% CI = 0.54–0.70). Conclusion After accounting for hospital and patient characteristics, lack of health insurance was associated with a higher likelihood of death for patients admitted to an ED or hospital for injuries sustained from a motor vehicle crash.