Sir,The recent publication economic outcome following severe head injury is very interesting.[1] Dhandapani et al. reported that “In patients of severe head injury, lower economic status is significantly associated with unfavorable outcome at three months, independent of other factors”.[1] Focusing on this finding, there are some questions for discussion. Whether this finding indicates the difference in quality of neurosurgery case management is a big question. Indeed, the case with poor underlying socioeconomic status might have poor physiological underlying that lead to poor outcome. However, the question is on the equity of case management. If there is inequity in care provision, it can be a problematic and ethical issue for consideration. In a recent report on following surgical procedure for traumatic injuries, it was reported that “The likelihood of placement in a rehabilitation center was significantly impacted by both race and insurance status”.[2]
Authors: Daithi S Heffernan; Roberto M Vera; Sean F Monaghan; Rajan K Thakkar; Matthew S Kozloff; Michael D Connolly; Shea C Gregg; Jason T Machan; David T Harrington; Charles A Adams; William G Cioffi Journal: J Trauma Date: 2011-03