Disparities in Adult and Pediatric Trauma Outcomes: a Systematic Review and Meta-Analysis
bit.ly shows its articles on its own site.
Read the article on bit.ly ↗Article · Jul 2020 · 1 min read
In brief
In brief
Systematic review and meta-analysis examining mortality disparities in trauma care across adult and pediatric populations. Analysis of 41 studies reveals uninsured patients have 22% higher odds of death and non-Caucasian patients have 18% higher mortality risk compared to insured and Caucasian patients respectively.
Written by the GCMD Library team from the article.
Background: Although safeguards requiring emergency care are provided regardless of a patient's payor status, disparate outcomes have been reported in trauma populations. The purpose of this systematic review and meta-analysis was to determine whether race/ethnicity or insurance status had an effect on mortality and to systematically present the literature in the adult and pediatric trauma populations during the last decade.
Methods: An online search of PubMed, Cochrane Library, Google Scholar, and SAGE Journals was performed for publications from January 2009 to March 2019. The Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines were used. The GRADE Working Group criteria were utilized to assess the evidence quality. A meta-analysis was conducted to compare mortality between insured/uninsured and Caucasian/non-Caucasian patients.
Results: Our search revealed 680 publications that qualified for evaluation. Of these, 41 were included in the final analysis. Twenty-six studies included adults only, nine studies included pediatric patients only, and six studies evaluated both. Twelve studies evaluated the effects of race/ethnicity, 18 examined insurance status, and 11 investigated both. Uninsured patients had 22% greater odds of death than insured patients (OR 1.22; CI 1.21-1.24). Non-Caucasian patients had 18% greater risk of death than Caucasian patients (OR 1.18; CI 1.17-1.20).
Conclusion: Both the adult and pediatric trauma populations suffer outcome disparities based on race/ethnicity and insurance status. Overall, patients without insurance coverage and minority groups (i.e., non-Caucasians) had worse outcomes, as measured by odds of death and all-cause mortality.
DOI: 10.1007/s00268-020-05591-2