Top

Gepubliceerd in:

04-09-2015

Insurance status and health-related quality-of-life disparities after trauma: results from a nationally representative survey in the US

Auteurs: Suliman Alghnam, Eric B. Schneider, Renan C. Castillo

Gepubliceerd in: Quality of Life Research | Uitgave 4/2016

Abstract

Purpose

To determine whether insurance status modifies the association between injuries and health-related quality of life (HRQOL) in a nationally representative sample of US adults.

Methods

This is a longitudinal, observational study using the pooled 2000–2006 Medical Expenditure Panel Survey (MEPS). A total of 50,225 adults (age ≥18) with or without injuries were included in the study. HRQOL was evaluated using the EuroQoL Health Index (EQ-5D), visual analog scale (VAS), and the SF-12 physical component score (PCS) and mental component score (MCS). A categorical variable of injury-insurance combinations was created (not injured-privately insured, not injured-publically insured, not injured-uninsured, injured-privately insured, injured-publically insured, or injured-uninsured) and was included in the linear regression models. Adjustment covariates included age, gender, education, race, diabetes, hypertension, and baseline self-reported health. Healthcare utilization was also examined among the study population by injury status and across insurance groups.

Results

Seven hundred and ten individuals reported injuries. Adjusted analyses showed that injured individuals with public insurance had lower EQ-5D (−0.25), VAS (−11.4), PCS (−8.5), and MCS (−4.9) than the privately insured controls, while uninsured had EQ-5D, VAS, PCS and MCS that were, respectively, −0.12, −7.2, −2.6 and −4.1 relative to privately insured controls. With the exception of hospital discharges, healthcare utilization among uninsured individuals was lower than those with public or private insurance.

Conclusions

We found injured individuals to have lower HRQOL than those without injuries, and this effect was exacerbated by insurance status. These findings call for interventions aimed to narrow the outcome disparity among injured in the US.

vorige artikel Is bad living better than good death? Impact of demographic and cultural factors on health state preference

volgende artikel Employment and insurance outcomes and factors associated with employment among long-term thyroid cancer survivors: a population-based study from the PROFILES registry

Englum, B. R., Villegas, C., Bolorunduro, O., Haut, E. R., Cornwell, E. E., Efron, D. T., & Haider, A. H. (2011). Racial, ethnic, and insurance status disparities in use of posthospitalization care after trauma. Journal of the American College of Surgeons, 213(6), 699–708. doi:10.1016/j.jamcollsurg.2011.08.017.CrossRefPubMedPubMedCentral

Dischinger, P. C., Read, K. M., Kufera, J. A., T. J. K., Ho, S. M., C.A. Burch et al. (2005). CIREN report: consequences and costs of lower—Extremity injuries. Washington, D.C.

Soni, P. A. (2011). Top 10 most costly conditions among men and women, 2008: Estimates for the U.S. civilian noninstitutionalized adult population, age 18 and older, statistical brief #331. July 2011. Agency for Healthcare Research and Quality, Rockville. http://www.meps.ahrq.gov/mepsweb/data_files/publications/st331/stat331.shtml.

Yeh, S., Uberoi, N., & Cohen, J. (2013). STATISTICAL BRIEF #397, (January), 1–7.

Nyman, J. A., Barleen, N. A., Dowd, B. E., Russell, D. W., Coons, S. J., & Sullivan, P. W. (2007). Quality-of-life weights for the US population: Self-reported health status and priority health conditions, by demographic characteristics. Medical Care, 45(7), 618–628. doi:10.1097/MLR.0b013e31803dce05.CrossRefPubMed

Pons-Villanueva, J., Rodríguez de Armenta, M. J., Martínez-González, M. A., & Seguí-Gómez, M. (2011). Longitudinal assessment of quality of life and its change in relation to motor vehicle crashes: the SUN (Seguimiento Universidad de Navarra) Cohort. The Journal of Trauma, 70(5), 1072–1077. doi:10.1097/TA.0b013e3181eaad92.CrossRefPubMed

Elnitsky, C. A., Andresen, E. M., Clark, M. E., McGarity, S., Hall, C. G., & Kerns, R. D. (2013). Access to the US Department of Veterans Affairs health system: Self-reported barriers to care among returnees of Operations Enduring Freedom and Iraqi Freedom. BMC Health Services Research, 13, 498. doi:10.1186/1472-6963-13-498.CrossRefPubMedPubMedCentral

Greene, W. R., Oyetunji, T. A., Bowers, U., Haider, A. H., Mellman, T. A., Cornwell, E. E., & Chang, D. C. (2010). Insurance status is a potent predictor of outcomes in both blunt and penetrating trauma. American Journal of Surgery, 199(4), 554–557. doi:10.1016/j.amjsurg.2009.11.005.CrossRefPubMed

Rosen, H., Saleh, F., Lipsitz, S. R., Meara, J. G., & Rogers, S. O. (2009). Lack of insurance negatively affects trauma mortality in US children. Journal of Pediatric Surgery, 44(10), 1952–1957. doi:10.1016/j.jpedsurg.2008.12.026.CrossRefPubMed

10.

Englum, B., Villegas, C., Stevens, K., Haut, E. R., Efron, D. T., & Haider, A. H. (2010). Relationship of insurance status to discharge location after trauma. Journal of the American College of Surgeons, 211(3), S98. doi:10.1016/j.jamcollsurg.2010.06.259.CrossRef

11.

Falor, A., Kim, D., Bricker, S., Neville, A., Bongard, F., Putnam, B., & Plurad, D. (2014). Insurance status predicts survival for trauma patients undergoing urgent intervention. The Journal of Surgical Research, 188(1), 238–242. doi:10.1016/j.jss.2013.12.003.CrossRefPubMed

12.

Maybury, R. S., Bolorunduro, O. B., Villegas, C., Haut, E. R., Stevens, K., Cornwell, E. E., & Haider, A. H. (2010). Pedestrians struck by motor vehicles further worsen race- and insurance-based disparities in trauma outcomes: the case for inner-city pedestrian injury prevention programs. Surgery, 148(2), 202–208. doi:10.1016/j.surg.2010.05.010.CrossRefPubMed

13.

Hadley, J. (2014). Insurance coverage, medical care use, and short-term health changes following an unintentional injury or the onset of a chronic condition. 297(10).

14.

Shafi, S., Marquez de la Plata, C., Diaz-Arrastia, R., Shipman, K., Carlile, M., Frankel, H., et al. (2007). Racial disparities in long-term functional outcome after traumatic brain injury. The Journal of Trauma, 63(6), 1263–1268. doi:10.1097/TA.0b013e31815b8f00. (discussion 1268–1270).CrossRefPubMed

15.

Bell, T. M., & Zarzaur, B. L. (2013). Insurance status is a predictor of failure to rescue in trauma patients at both safety net and non-safety net hospitals. The Journal of Trauma and Acute Care Surgery, 75(4), 728–733. doi:10.1097/TA.0b013e3182a53aaa.CrossRefPubMed

16.

Gaskin, D.J., & Richard, P. (2012). The economic costs of pain in the United States. The Journal of Pain, 13(8),715–724.CrossRefPubMed

17.

Cohen, J. W., Monheit, A. C., Beauregard, K. M., Cohen, S. B., Doris, C., Potter, D. E. B. et al. (1996). Data survey: A National Health Resource Expenditure Panel The Medical, 33(4), 373–389.

18.

Ware, J. E., Kosinski, M., & Keller, S. D. (2012). A 12-Item Short-Form Health Survey of scales and preliminary construction tests of reliability and validity, 34(3), 220–233.

19.

Ware, J. E. (1996). How to score the SF-12 physical and mental health summary scales (2nd ed.). Lincoln RI: Quality Metric Inc, and the Health Assessment Lab.

20.

McDowell, I. N. C. (1996). Measuring health: A guide to rating scales and questionnaires (2nd ed.). New York: Oxford University Press.

21.

The EuroQol Group. (2011). http://www.euroqol.org/download/ref.pdf.

22.

Sullivan, P. W., Lawrence, W. F., & Ghushchyan, V. (2005). A national catalog of preference-based scores for chronic conditions in the United States. Medical Care,. doi:10.1097/01.mlr.0000172050.67085.4f.

23.

Samsa, G., Edelman, D., Rothman, M. L., Williams, G. R., Lipscomb, J., & Matchar, D. (1999). Determining clinically important differences in health status measures. PharmacoEconomics, 15(2), 141–155. doi:10.2165/00019053-199915020-00003.CrossRefPubMed

24.

Luo, N., Johnson, J., & Coons, S. J. (2010). Using instrument-defined health state transitions to estimate minimally important differences for four preference-based health-related quality of life instruments. Medical care, 48(4), 365–371. http://www.ncbi.nlm.nih.gov/pubmed/20355266.

25.

Fu, A. Z., Qiu, Y., Radican, L., & Luo, N. (2011). Marginal differences in health-related quality of life of diabetic patients with and without macrovascular comorbid conditions in the United States. Quality of Life Research : An International Journal of Quality of Life Aspects of Treatment, Care and Rehabilitation, 20(6), 825–832. doi:10.1007/s11136-010-9819-x.CrossRef

26.

Fu, A. Z., & Kattan, M. W. (2006). Racial and ethnic differences in preference-based health status measure. Current Medical Research and Opinion, 22(12), 2439–2448. doi:10.1185/030079906X148391.CrossRefPubMed

27.

Mukherjee, B., Ou, H.-T., Wang, F., & Erickson, S. R. (2011). A new comorbidity index: The health-related quality of life comorbidity index. Journal of Clinical Epidemiology, 64(3), 309–319. doi:10.1016/j.jclinepi.2010.01.025.CrossRefPubMed

28.

Sullivan, P. W., Smith, K. L., Ghushchyan, V. H., Globe, D. R., Lin, S.-L., & Globe, G. (2013). Asthma in USA: its impact on health-related quality of life. The Journal of Asthma: Official Journal of the Association for the Care of Asthma, 50(8), 891–899. doi:10.3109/02770903.2013.813035.CrossRef

29.

Diehr, P., Johnson, L. L., Patrick, D. L., & Psaty, B. (2005). Methods for incorporating death into health-related variables in longitudinal studies. Journal of Clinical Epidemiology, 58, 1115–1124. doi:10.1016/j.jclinepi.2005.05.002.CrossRefPubMed

30.

Zarzaur, B. L., Stair, B. R., Magnotti, L. J., Croce, M. A., & Fabian, T. C. (2010). Insurance type is a determinant of 2-year mortality after non-neurologic trauma. The Journal of Surgical Research, 160(2), 196–201. doi:10.1016/j.jss.2009.06.059.CrossRefPubMedPubMedCentral

31.

Miller, N. A., Kirk, A., Kaiser, M. J., & Glos, L. (2014). The relation between health insurance and health care disparities among adults with disabilities. American Journal of Public Health, 104(3), e85–e93. doi:10.2105/AJPH.2013.301478.CrossRefPubMedPubMedCentral

32.

Schwartz, D. A., Hui, X., Schneider, E. B., Ali, M. T., Canner, J. K., Leeper, W. R., & Haider, A. H. (2014). Worse outcomes among uninsured general surgery patients: does the need for an emergency operation explain these disparities? Surgery, 156(2), 345–351. doi:10.1016/j.surg.2014.04.039.CrossRefPubMed

33.

Health Insruance Highlights: 2012. (2013). http://www.census.gov/hhes/www/hlthins/data/incpovhlth/2012/highlights.html.

34.

Sanjeev Sabharwal, M. D., Caixia Zhao, M. D., Emily McClemens, P. A.-C., Arlene Kaufmann, R., & Background. (2007). Pediatric orthopaedic patients presenting to a university emergency department after visiting another emergency department. Journal of Pediatric Orthopedics, 27(6), 690–694.CrossRefPubMed

35.

Binder, E. F., Brown, M., Sinacore, D. R., Steger-May, K., Yarasheski, K. E., & Schechtman, K. B. (2004). Effects of extended outpatient rehabilitation after hip fracture: A randomized controlled trial. JAMA, the Journal of the American Medical Association, 292(7), 837–846. doi:10.1001/jama.292.7.837.CrossRefPubMed

36.

Bleakley, C. M., O’Connor, S. R., Tully, M. A., Rocke, L. G., Macauley, D. C., Bradbury, I., & McDonough, S. M. (2010). Effect of accelerated rehabilitation on function after ankle sprain: Randomised controlled trial. BMJ (Clinical Research ed.), 340, c1964. doi:10.1136/bmj.c1964.CrossRef

37.

Whitlock, J. A., & Hamilton, B. B. (1995). Functional outcome after rehabilitation for severe traumatic brain injury. Archives of Physical Medicine and Rehabilitation, 76(12), 1103–1112. http://www.ncbi.nlm.nih.gov/pubmed/8540785.

38.

Pezzin, L. E., Dillingham, T. R., & MacKenzie, E. J. (2000). Rehabilitation and the long-term outcomes of persons with trauma-related amputations. Archives of Physical Medicine and Rehabilitation, 81(3), 292–300. http://www.ncbi.nlm.nih.gov/pubmed/10724073.

39.

Castillo, R. C., MacKenzie, E. J., Webb, L. X., Bosse, M. J., & Avery, J. (2005). Use and perceived need of physical therapy following severe lower-extremity trauma. Archives of Physical Medicine and Rehabilitation, 86(9), 1722–1728. doi:10.1016/j.apmr.2005.03.005.CrossRefPubMed

40.

Score, I. S., Score, R. T., & Arizona, I. (2009). Downwardly mobile. Archives of Surgery, 144(11), 1006–1012.CrossRef

41.

Martin, L. T., & Parker, R. M. (2011). Insurance expansion and health literacy, 306(8), 11–12. doi:10.1001/jama.2011.1212.

42.

Sentell, T. (2012). Implications for reform: survey of California adults suggests low health literacy predicts likelihood of being uninsured. Health Affairs, 31(5), 1039–1048. doi:10.1377/hlthaff.2011.0954.CrossRefPubMed

43.

Hill, S. C. (2007). The accuracy of reported insurance status in the MEPS. Inquiry: The Journal of Health Care Organization, Provision, and Financing 44(4), 443–468.PubMed

44.

Alghnam, S., Palta, M., Remington, P. L., Mullahy, J., & Durkin, M. S. (2013). The association between motor vehicle injuries and health-related quality of life: a longitudinal study of a population-based sample in the United States. Quality of Life Research : An International Journal of Quality of Life Aspects of Treatment, Care and Rehabilitation, 23(1), 119–127. doi:10.1007/s11136-013-0444-3.CrossRef

Titel: Insurance status and health-related quality-of-life disparities after trauma: results from a nationally representative survey in the US
Auteurs: Suliman Alghnam
Eric B. Schneider
Renan C. Castillo
Publicatiedatum: 04-09-2015
Uitgeverij: Springer International Publishing
Gepubliceerd in: Quality of Life Research / Uitgave 4/2016
Print ISSN: 0962-9343
Elektronisch ISSN: 1573-2649
DOI: https://doi.org/10.1007/s11136-015-1126-0

Andere artikelen Uitgave 4/2016

Association between nutritional status and subjective health status in chronically ill children attending special schools

Open Access

Open Access

Paving the way for the use of the SDQ in economic evaluations of school-based population health interventions: an empirical analysis of the external validity of SDQ mapping algorithms to the CHU9D in an educational setting

Open Access

Bohn Stafleu van Loghum

Insurance status and health-related quality-of-life disparities after trauma: results from a nationally representative survey in the US

Abstract

Purpose

Methods

Results

Conclusions

Andere artikelen Uitgave 4/2016

Association between nutritional status and subjective health status in chronically ill children attending special schools

Linkage between the PROMIS® pediatric and adult emotional distress measures

Mapping the EORTC QLQ-C30 onto the EQ-5D-3L: assessing the external validity of existing mapping algorithms

Long-term effects of goal disturbance and adjustment on well-being in cancer patients

Paving the way for the use of the SDQ in economic evaluations of school-based population health interventions: an empirical analysis of the external validity of SDQ mapping algorithms to the CHU9D in an educational setting

Validation of an innovative instrument of Positive Oral Health and Well-Being (POHW)

Bohn Stafleu van Loghum

Deel dit onderdeel of sectie (kopieer de link)

Abstract

Purpose

Methods

Results

Conclusions

Log in om toegang te krijgen

Association between nutritional status and subjective health status in chronically ill children attending special schools

Linkage between the PROMIS® pediatric and adult emotional distress measures

Mapping the EORTC QLQ-C30 onto the EQ-5D-3L: assessing the external validity of existing mapping algorithms

Long-term effects of goal disturbance and adjustment on well-being in cancer patients

Paving the way for the use of the SDQ in economic evaluations of school-based population health interventions: an empirical analysis of the external validity of SDQ mapping algorithms to the CHU9D in an educational setting

Validation of an innovative instrument of Positive Oral Health and Well-Being (POHW)