title: The Impact of Payer Source on Trauma Outcomes in a Pediatric Population.
abstract: Determine if there were differences in conclusions drawn regarding disparities in trauma outcomes based on literature-derived payer source definitions in a pediatric population.
  
  
  
  Retrospective registry review of admitted pediatric trauma patients (≤17 years of age) at a level II pediatric trauma facility. Eligible patients were categorized into 3 payer source definitions: definition 1: commercially insured, Medicaid, uninsured; definition 2: insured, uninsured; definition 3: commercially insured, underinsured. Logistic regression was used to determine the influence of payer source on outcomes.
  
  
  
  Payer source was not significant in definition 1, 2, or 3 for intensive care unit length of stay (LOS), hospital LOS, medical consults, or mortality. For hospital disposition, payer source was significant in definition 1, the uninsured were 90% less likely than commercially insured to be discharged to continued care. In definition 2, the uninsured were 88% less likely than insured to be discharged to continued care. In definition 3, the underinsured were 57% less likely than commercially insured to be discharged to continued care.
  
  
  
  Differences between the literature-derived definitions were not observed and therefore conclusions drawn did not differ across definitions. The investigation demonstrated payer source was not associated with in-hospital outcomes (intensive care unit LOS, hospital LOS, medical consults, and mortality), but was with posthospital outcomes. Findings warrant future examinations on the categorization of payer source in pediatric patients and hospital disposition to gain a greater understanding of disparities related to payer source in pediatric trauma, specifically in terms of posthospital care.
authors.affiliation: Department of Family and Community Medicine, felecia.lee@via-christi.org.
authors.forename: Felecia A
authors.initials: FA
authors.lastname: Lee
authors.affiliation: Department of Family and Community Medicine.
authors.forename: Ashley M
authors.initials: AM
authors.lastname: Hervey
authors.affiliation: The University of Kansas School of Medicine-Wichita, Wichita, Kansas; and.
authors.forename: Arash
authors.initials: A
authors.lastname: Sattarin
authors.affiliation: The University of Kansas School of Medicine-Wichita, Wichita, Kansas; and.
authors.forename: Aaron
authors.initials: A
authors.lastname: Deeds
authors.affiliation: Department of Family and Community Medicine.|Departments of Trauma Services, and.
authors.forename: Gina M
authors.initials: GM
authors.lastname: Berg
authors.affiliation: Pediatric Trauma, Wesley Healthcare, Wichita, Kansas.
authors.forename: Kimberly
authors.initials: K
authors.lastname: Molik
mesh_terms: D002648:Child; D003266:Continuity of Patient Care; D005260:Female; D006801:Humans; D019458:Insurance Coverage; D015278:Intensive Care Units, Pediatric; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008484:Medicaid; D017057:Medically Uninsured; D010351:Patient Discharge; D012017:Referral and Consultation; D012042:Registries; D012189:Retrospective Studies; D014481:United States / Q000453:epidemiology; D014947:Wounds and Injuries / Q000453:epidemiology*