title: The Probability of Hospitalizations for Mild-to-Moderate Injuries by Trauma Center Ownership Type.
abstract: To corroborate anecdotal evidence with systematic evidence of a lower threshold for admission among for-profit hospitals.
  
  
  
  The study used Florida emergency department and hospital discharge datasets for 2012 to 2014. The treatment variable of interest was for-profit-designated trauma center status. The dependent variable indicated whether a patient with mild-to-moderate injuries was admitted after presenting as a trauma alert and then discharged to home. A separate analysis was conducted of discharges that had a 1-day length of stay.
  
  
  
  Generalized estimation equations with logistic distribution models were used to control for the confounding influences and developed for four groups of patients: ICISS = 1 (no probability of mortality), ICISS ≥ 0.99, ICISS ≥ 0.95, and ICISS ≥ 0.85 (zero to 15 percent probability of mortality, which includes all mild and moderate injury patients).
  
  
  
  For the ICISS = 1 and ICISS ≥ 0.99 models, the centers' for-profit status was the most important predictor. In the ICISS ≥ 0.95 and ICISS ≥ 0.85 models, injury type played a more important role, but for-profit status remained important. For patients with a 1-day stay, for-profit status was associated with an even higher probability of hospitalization.
  
  
  
  Considerable differences exist between for-profit and not-for-profit trauma centers concerning hospitalization among the study population, which may be explained by supplier-induced demand.
authors.affiliation: Department of Health Policy and Management, College of Public Health, University of South Florida, Tampa, FL.
authors.forename: Etienne E
authors.initials: EE
authors.lastname: Pracht
authors.affiliation: Department of Health Policy and Management, College of Public Health, University of South Florida, Tampa, FL.
authors.forename: Barbara
authors.initials: B
authors.lastname: Langland-Orban
authors.affiliation: Department of Health Policy and Management, College of Public Health, University of South Florida, Tampa, FL.
authors.forename: Jessica L
authors.initials: JL
authors.lastname: Ryan
mesh_terms: D000367:Age Factors; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005431:Florida; D006742:Hospital Bed Capacity / Q000706:statistics & numerical data; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D019458:Insurance Coverage / Q000706:statistics & numerical data; D007348:Insurance, Health / Q000706:statistics & numerical data; D010067:Ownership / Q000706:statistics & numerical data*; D044469:Racial Groups; D012737:Sex Factors; D012959:Socioeconomic Factors; D014193:Trauma Centers / Q000706:statistics & numerical data*; D015599:Trauma Severity Indices; D014947:Wounds and Injuries / Q000401:mortality / Q000628:therapy*
keywords: Incentives in Health Care; hospitals; ownership; supplier-induced demand