Molly M Fuentes1,2,3, Megan Moore4,5, Qian Qiu4, Alex Quistberg6,7, Matthew Frank8, Monica S Vavilala4,9. 1. Department of Rehabilitation Medicine, University of Washington, Seattle, WA, USA. molly.fuentes@seattlechildrens.org. 2. Harborview Injury Prevention and Research Center, Seattle, WA, USA. molly.fuentes@seattlechildrens.org. 3. Center for Child Health Behavior and Development, Seattle Children's Research Institute, Seattle, WA, USA. molly.fuentes@seattlechildrens.org. 4. Harborview Injury Prevention and Research Center, Seattle, WA, USA. 5. School of Social Work, University of Washington, Seattle, WA, USA. 6. Department of Environmental & Occupational Health, Drexel University, Philadelphia, PA, USA. 7. Urban Health Collaborative, Drexel University, Philadelphia, PA, USA. 8. Albuquerque Area Southwest Tribal Epidemiology Center, Albuquerque, NM, USA. 9. Department of Anesthesiology and Pain Medicine, University of Washington, Seattle, WA, USA.
Abstract
OBJECTIVE: This study compares characteristics of American Indian/Alaska Natives (AI/AN) and non-Hispanic Whites (NHW) hospitalized for traumatic injury and examines the effect of race on hospital disposition. METHODS: Using 2007-2014 National Trauma Data Bank data, we described differences in demographic and injury characteristics between AI/AN (n = 39,656) and NHWs (n = 3,309,484) hospitalized with traumatic injuries. Multivariable regressions, adjusted for demographic and injury characteristics, compared in-hospital mortality and the risk of discharge to different dispositions (inpatient rehabilitation/long-term care facility, skilled nursing facility, home with home health services) rather than home between AI/AN and NHW patients. RESULTS: Compared to NHWs, a higher proportion of AI/ANs were age 19-44 (49% versus 27%) years and hospitalized with assault-related injuries (25% versus 5%). AI/ANs had lower odds of dying than NHWs during hospitalization (adjusted odds ratio (aOR) 0.72, 95% CI 0.63-0.84). However, AI/ANs also had lower odds than NHWs to discharge to locations with additional health services even after controlling for injury severity (inpatient rehabilitation/long-term care facilities aOR 0.79, 95% CI 0.67-0.93; skilled nursing facility aOR 0.70, 95% CI 0.49-0.98; home with home health services aOR 0.62, 95% CI 0.49-0.79). CONCLUSIONS: Injury patterns and acute hospitalization outcomes were significantly different for AI/ANs compared to NHWs. Injury prevention strategies targeting AI/ANs should reflect these differential injury patterns. Outcomes such as disability and access to rehabilitation services should be included when considering the burden of injury among AI/AN communities.
OBJECTIVE: This study compares characteristics of American Indian/Alaska Natives (AI/AN) and non-Hispanic Whites (NHW) hospitalized for traumatic injury and examines the effect of race on hospital disposition. METHODS: Using 2007-2014 National Trauma Data Bank data, we described differences in demographic and injury characteristics between AI/AN (n = 39,656) and NHWs (n = 3,309,484) hospitalized with traumatic injuries. Multivariable regressions, adjusted for demographic and injury characteristics, compared in-hospital mortality and the risk of discharge to different dispositions (inpatient rehabilitation/long-term care facility, skilled nursing facility, home with home health services) rather than home between AI/AN and NHW patients. RESULTS: Compared to NHWs, a higher proportion of AI/ANs were age 19-44 (49% versus 27%) years and hospitalized with assault-related injuries (25% versus 5%). AI/ANs had lower odds of dying than NHWs during hospitalization (adjusted odds ratio (aOR) 0.72, 95% CI 0.63-0.84). However, AI/ANs also had lower odds than NHWs to discharge to locations with additional health services even after controlling for injury severity (inpatient rehabilitation/long-term care facilities aOR 0.79, 95% CI 0.67-0.93; skilled nursing facility aOR 0.70, 95% CI 0.49-0.98; home with home health services aOR 0.62, 95% CI 0.49-0.79). CONCLUSIONS: Injury patterns and acute hospitalization outcomes were significantly different for AI/ANs compared to NHWs. Injury prevention strategies targeting AI/ANs should reflect these differential injury patterns. Outcomes such as disability and access to rehabilitation services should be included when considering the burden of injury among AI/AN communities.
Entities:
Keywords:
Alaska Native; American Indian; Health care disparity; Hospitalization; Rehabilitation; Trauma
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