title: Potential disparities in trauma: the undocumented Latino immigrant.
abstract: BACKGROUND
  Little is known about the quality of trauma care undocumented immigrants receive. Documentation status may serve as a risk factor for health disparities. We hypothesized that undocumented Latino immigrants have an increased risk of mortality after trauma compared with Latinos with legal residence.
  
  
  METHODS
  The medical records for Latino trauma patients at our university-based trauma center between 2007 and 2012 were retrospectively reviewed. Undocumented status was defined using two criteria: (1) lack of social security number and (2) insurance status as either "county," the local program that covers undocumented immigrants, or "self pay". Regression models were used to estimate the comparable risks of in-hospital mortality.
  
  
  RESULTS
  Out of 2441 Latino trauma patients treated at our institution during the study period, 465 were undocumented. Latinos with legal residence and undocumented Latinos did not differ with regard to in-hospital mortality (3.4% versus 3.9%, respectively; P = 0.61). We found no association between documentation status and in-hospital mortality after trauma (odds ratio = 1.12 [0.43, 2.9]; P = 0.81). The independent predictors of in-hospital mortality included age, injury severity score, penetrating mechanism, and lack of private insurance but not documentation status.
  
  
  CONCLUSIONS
  Undocumented Latino immigrants did not have an increased risk of in-hospital mortality after trauma; however, being uninsured was associated with a higher risk of death after trauma. For Latinos, we found no disparities based on immigration status for mortality after trauma, though disparities based on insurance status continue to persist.
authors.affiliation: Department of Surgery, University of California, San Francisco - East Bay, 1411 East 31st Street, Oakland, CA 94602.
authors.forename: Vincent E
authors.initials: VE
authors.lastname: Chong
authors.affiliation: Department of Surgery, University of California, San Francisco - East Bay, 1411 East 31st Street, Oakland, CA 94602.
authors.forename: Wayne S
authors.initials: WS
authors.lastname: Lee
authors.affiliation: Department of Surgery, University of California, San Francisco - East Bay, 1411 East 31st Street, Oakland, CA 94602. Electronic address: vchong@alamedahealthsystem.org.
authors.forename: Gregory P
authors.initials: GP
authors.lastname: Victorino
mesh_terms: D000328:Adult; D054242:Emigrants and Immigrants; D005260:Female; D054625:Healthcare Disparities; D006630:Hispanic or Latino; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D014947:Wounds and Injuries / Q000208:ethnology / Q000628:therapy*
keywords: Immigrant health; Outcome assessment; Trauma