Comparing Severely Injured Trauma Patients Admitted to Investor-Owned versus Public and Not-For-Profit Hospitals Reveals Opportunities for Improvement in the US-Reference-Cited by-同舟云学术

Comparing Severely Injured Trauma Patients Admitted to Investor-Owned versus Public and Not-For-Profit Hospitals Reveals Opportunities for Improvement in the US

Published:2023-03-02 Issue:7 Volume:89 Page:3140-3144
ISSN:0003-1348
Container-title:The American Surgeon™
language:en
Short-container-title:The American Surgeon™

Author:

Hernandez Jennifer¹,Spector Chelsea L.¹,Quintero Luis A.¹,Shatawi Zaineb¹,Rosenthal Andrew²,Curcio Gary³,Buicko Jessica L.⁴,Parreco Joshua P.²

Affiliation:

1. General Surgery Residency, Memorial Healthcare System, Hollywood, FL, USA

2. Trauma Critical Care Surgery, Florida Atlantic University, Hollywood, FL, USA

3. Trauma Critical Care Surgery, University of South Florida, Fort Pierce, FL, USA

4. Endocrine, Breast, and General Surgery, Florida Atlantic University, Boynton Beach, FL, USA

Abstract

Background Non-elderly trauma patients represent the largest portion of preventable years of life loss in the US. The purpose of this study was to compare outcomes in patients admitted to investor-owned vs public and not-for-profit hospitals across the US. Material and Methods The Nationwide Readmissions Database 2018 was queried for trauma patients with an Injury Severity Score greater than 15 and age 18-65 years. The primary outcome was mortality; secondary outcomes were prolonged length of stay (LOS) greater than 30 days, readmission within 30 days, and readmission to a different hospital. Patients admitted to investor-owned hospitals were compared to public and not-for-profit hospitals. Univariable analysis was performed using chi-squared tests. Multivariable logistic regression was performed for each outcome. Results 157 945 patients were included with 11.0% (n = 17 346) admitted to investor-owned hospitals. The overall mortality rate and prolonged LOS were similar for both groups. The overall readmission rate was 9.2% (n = 13 895), with the rate in investor-owned hospitals at 10.5% (n = 1,739, P < .001). Multivariable logistic regression revealed investor-owned hospitals had an increased risk of readmission (OR 1.2 [1.1-1.3] P < .001) and readmission to a different hospital (OR 1.3 [1.2-1.5] P < .001). Discussion Severely injured trauma patients have similar rates of mortality and prolonged length of stay in investor-owned vs public and not-for-profit hospitals. However, patients admitted to investor-owned hospitals have an increased risk of readmission and readmission to different hospitals. Efforts to improve outcomes after trauma must consider hospital ownership and readmission to different hospitals.

Publisher

SAGE Publications

Subject

General Medicine

Link

http://journals.sagepub.com/doi/pdf/10.1177/00031348231160818

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