Abstract
Background: We compared insurance status among three groups of ambulatory patients with an operatively treated fracture of the distal part of the radius or of the ankle in order to determine if insurance status affected continuity of care. The patients were categorized as having received initial care at our institution, having received initial care elsewhere with an identifiable reason for transfer to a tertiary care center, or having received initial care elsewhere with no identifiable reason for transfer. Methods: We conducted a retrospective review of 697 patients with an operatively treated distal radial fracture or ankle fracture who had received their definitive treatment at a level-I trauma center. Demographic data, the mechanism of injury, the insurance type, and the location of the initial care were recorded. Results: The proportion of uninsured or underinsured patients in the group that had had their initial treatment at our trauma center was similar to that in the group that had had a specific reason to seek definitive care with us (64% and 63%, p < 0.832). However, the proportion of uninsured or underinsured patients was significantly larger in the group that had not received initial care from us and had no specific reason to receive definitive care from us (82% vs. 63%, p < 0.001). With other variables held constant, the odds of being underinsured or uninsured were 2.53 times greater for the patients initially treated elsewhere who had no specific reason to receive definitive treatment from us. Conclusions: These results suggest that non medical reasons play a role in determining where ambulatory patients with fractures requiring operative treatment are able to receive definitive care. Patients without specific medical or non medical reasons to receive definitive care at our center were significantly more likely to be uninsured or underinsured.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 680-685 |
| Number of pages | 6 |
| Journal | Journal of Bone and Joint Surgery - Series A |
| Volume | 93 |
| Issue number | 7 |
| DOIs | |
| State | Published - Apr 6 2011 |
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ASJC Scopus subject areas
- Surgery
- Orthopedics and Sports Medicine
Cite this
Does insurance status affect continuity of care for ambulatory patients with operative fractures? / Wolinsky, Philip R; Kim, Sunny H; Quackenbush, Michael.
In: Journal of Bone and Joint Surgery - Series A, Vol. 93, No. 7, 06.04.2011, p. 680-685.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Does insurance status affect continuity of care for ambulatory patients with operative fractures?
AU - Wolinsky, Philip R
AU - Kim, Sunny H
AU - Quackenbush, Michael
PY - 2011/4/6
Y1 - 2011/4/6
N2 - Background: We compared insurance status among three groups of ambulatory patients with an operatively treated fracture of the distal part of the radius or of the ankle in order to determine if insurance status affected continuity of care. The patients were categorized as having received initial care at our institution, having received initial care elsewhere with an identifiable reason for transfer to a tertiary care center, or having received initial care elsewhere with no identifiable reason for transfer. Methods: We conducted a retrospective review of 697 patients with an operatively treated distal radial fracture or ankle fracture who had received their definitive treatment at a level-I trauma center. Demographic data, the mechanism of injury, the insurance type, and the location of the initial care were recorded. Results: The proportion of uninsured or underinsured patients in the group that had had their initial treatment at our trauma center was similar to that in the group that had had a specific reason to seek definitive care with us (64% and 63%, p < 0.832). However, the proportion of uninsured or underinsured patients was significantly larger in the group that had not received initial care from us and had no specific reason to receive definitive care from us (82% vs. 63%, p < 0.001). With other variables held constant, the odds of being underinsured or uninsured were 2.53 times greater for the patients initially treated elsewhere who had no specific reason to receive definitive treatment from us. Conclusions: These results suggest that non medical reasons play a role in determining where ambulatory patients with fractures requiring operative treatment are able to receive definitive care. Patients without specific medical or non medical reasons to receive definitive care at our center were significantly more likely to be uninsured or underinsured.
AB - Background: We compared insurance status among three groups of ambulatory patients with an operatively treated fracture of the distal part of the radius or of the ankle in order to determine if insurance status affected continuity of care. The patients were categorized as having received initial care at our institution, having received initial care elsewhere with an identifiable reason for transfer to a tertiary care center, or having received initial care elsewhere with no identifiable reason for transfer. Methods: We conducted a retrospective review of 697 patients with an operatively treated distal radial fracture or ankle fracture who had received their definitive treatment at a level-I trauma center. Demographic data, the mechanism of injury, the insurance type, and the location of the initial care were recorded. Results: The proportion of uninsured or underinsured patients in the group that had had their initial treatment at our trauma center was similar to that in the group that had had a specific reason to seek definitive care with us (64% and 63%, p < 0.832). However, the proportion of uninsured or underinsured patients was significantly larger in the group that had not received initial care from us and had no specific reason to receive definitive care from us (82% vs. 63%, p < 0.001). With other variables held constant, the odds of being underinsured or uninsured were 2.53 times greater for the patients initially treated elsewhere who had no specific reason to receive definitive treatment from us. Conclusions: These results suggest that non medical reasons play a role in determining where ambulatory patients with fractures requiring operative treatment are able to receive definitive care. Patients without specific medical or non medical reasons to receive definitive care at our center were significantly more likely to be uninsured or underinsured.
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U2 - 10.2106/JBJS.J.00020
DO - 10.2106/JBJS.J.00020
M3 - Article
VL - 93
SP - 680
EP - 685
JO - Journal of Bone and Joint Surgery - American Volume
JF - Journal of Bone and Joint Surgery - American Volume
SN - 0021-9355
IS - 7
ER -