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- Title
The Probability of Hospitalizations for Mild-to-Moderate Injuries by Trauma Center Ownership Type.
- Authors
Pracht, Etienne E.; Langland‐Orban, Barbara; Ryan, Jessica L.; Langland-Orban, Barbara
- Abstract
<bold>Objective: </bold>To corroborate anecdotal evidence with systematic evidence of a lower threshold for admission among for-profit hospitals.<bold>Data Sources: </bold>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.<bold>Study Design: </bold>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).<bold>Principal Findings: </bold>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.<bold>Conclusions: </bold>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.
- Subjects
UNITED States; FLORIDA; HOSPITAL care; WOUND care; TRAUMA centers; MORTALITY; MEDICAL care; INSURANCE statistics; HEALTH insurance statistics; HOSPITAL utilization statistics; ACQUISITION of property; AGE distribution; HOSPITAL emergency services; POPULATION; SEX distribution; WOUNDS &; injuries; SOCIOECONOMIC factors; TRAUMA severity indices
- Publication
Health Services Research, 2018, Vol 53, Issue 1, p35
- ISSN
0017-9124
- Publication type
journal article
- DOI
10.1111/1475-6773.12646