Racial and ethnic disparities in discharge planning among trauma patients in the United States

IF 2.7 3区医学 Q1 SURGERY

American journal of surgery Pub Date : 2025-04-18 DOI:10.1016/j.amjsurg.2025.116352

Charlotte B. Smith, Andrew Schneider, Daryhl Johnson, Anthony Charles, Jared Gallaher

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引用次数: 0

Abstract

Introduction

Trauma patients often require post-discharge services, including home health, nursing care, or inpatient rehabilitation, but disparities may exist.

Methods

We analyzed the US National Trauma Data Bank (2011–2021). Insured patients that survived to discharge were stratified by race and ethnicity (non-Hispanic White; non-Hispanic Black; Hispanic; non-Hispanic Asian), and propensity score matched based on age, sex, insurance type, Charlson Comorbidity Index, and Injury Severity Score (ISS). An ordered logistic regression was performed on the matched cohorts to estimate the odds ratio of receiving a higher level of discharge services compared to white patients.

Results

We analyzed 7,172,601 patients. Race and ethnicity composition was 72.8 % non-Hispanic White, 14.6 % non-Hispanic Black, 10.4 % Hispanic, and 2.2 % non-Hispanic Asian. Compared to White patients, for non-Hispanic Black patients, the odds ratio of a higher level of discharge services was 0.84 (0.84, 0.85); for Hispanic patients, 0.76 (0.75, 0.76); and for non-Hispanic Asian patients, 0.85 (0.84, 0.86).

Conclusions

In a propensity-matched cohort, all analyzed minority groups had lower odds of receiving a higher level of discharge services than White patients.

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美国创伤患者出院计划中的种族差异

创伤患者通常需要出院后的服务，包括家庭健康、护理或住院康复，但可能存在差异。方法我们分析了美国国家创伤数据库（2011-2021）。存活至出院的被保险患者按种族和民族（非西班牙裔白人；非西班牙裔黑人；西班牙裔；非西班牙裔亚洲人）分层，并根据年龄、性别、保险类型、查尔森共病指数和损伤严重程度评分（ISS）匹配倾向评分。对匹配的队列进行有序逻辑回归，以估计与白人患者相比接受更高水平出院服务的比值比。结果我们分析了7172601名患者。种族和民族构成为72.8% 非西班牙裔白人，14.6% 非西班牙裔黑人，10.4% 西班牙裔，2.2% 非西班牙裔亚洲人。与白人患者相比，非西班牙裔黑人患者获得更高水平出院服务的比值比为0.84（0.84，0.85）；西班牙裔患者为0.76（0.75，0.76）；非西班牙裔亚裔患者为0.85（0.84，0.86）。结论在倾向匹配的队列中，所有被分析的少数群体接受更高水平出院服务的几率均低于白人患者。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

American journal of surgery 医学-外科

CiteScore

5.00

自引率

6.70%

发文量

570

审稿时长

56 days

期刊介绍： The American Journal of Surgery® is a peer-reviewed journal designed for the general surgeon who performs abdominal, cancer, vascular, head and neck, breast, colorectal, and other forms of surgery. AJS is the official journal of 7 major surgical societies* and publishes their official papers as well as independently submitted clinical studies, editorials, reviews, brief reports, correspondence and book reviews.