title: The effect of methodology in determining disparities in in-hospital mortality of trauma patients based on payer source.
abstract: A retrospective registry review of adult patients admitted to a Level I trauma center sought to determine whether results regarding in-hospital mortality associated with payer source vary on the basis of methodology. Patients were categorized into 4 literature-derived definitions (Definition 1: insured and uninsured; Definition 2: commercially insured, publicly insured, and uninsured; Definition 3: commercially insured, Medicaid, Medicare, and uninsured; and Definition 4: commercially insured, Medicaid, and uninsured). In-hospital mortality differences were found in Definitions 2 and 3, and when reclassifying dual-eligible Medicare/Medicaid into socioeconomic and age indicators. Variations in methodology culminated in results that could be interpreted with differing conclusions.
authors.affiliation: Wesley Medical Center Trauma Services, Wichita, Kansas (Drs Berg and Harrison and Ms Basham-Saif); Department of Family and Community Medicine (Drs Berg and Lee and Ms Hervey) and Department of Preventive Medicine and Public Health (Dr Hines), University of Kansas School of Medicine-Wichita, Wichita, Kansas.
authors.forename: Gina M
authors.initials: GM
authors.lastname: Berg
authors.forename: Felecia A
authors.initials: FA
authors.lastname: Lee
authors.forename: Ashley M
authors.initials: AM
authors.lastname: Hervey
authors.forename: Robert B
authors.initials: RB
authors.lastname: Hines
authors.forename: Angela
authors.initials: A
authors.lastname: Basham-Saif
authors.forename: Paul B
authors.initials: PB
authors.lastname: Harrison
mesh_terms: D000328:Adult; D000368:Aged; D015331:Cohort Studies; D016001:Confidence Intervals; D005260:Female; D006295:Health Resources / Q000191:economics*; D054625:Healthcare Disparities; D017052:Hospital Mortality; D006801:Humans; D016015:Logistic Models; D008297:Male; D008484:Medicaid / Q000191:economics / Q000706:statistics & numerical data; D017057:Medically Uninsured / Q000706:statistics & numerical data; D006278:Medicare / Q000191:economics / Q000706:statistics & numerical data; D008875:Middle Aged; D012042:Registries; D012189:Retrospective Studies; D018709:Statistics, Nonparametric; D014193:Trauma Centers / Q000191:economics; D015599:Trauma Severity Indices; D014481:United States; D014947:Wounds and Injuries / Q000175:diagnosis / Q000191:economics / Q000401:mortality* / Q000628:therapy*