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Trauma Patients Without Insurance Decreased After ACA, But Mortality Odds Increased


December 28, 2020

Trauma patients covered by Medicare or Medicaid had improved mortality after implementation of the Patient Protection and Affordable Care Act (ACA) compared with before the ACA, but uninsured trauma patients did not. Researchers published their findings in the Journal of the American College of Surgeons.

The study included data for 7538 adults pulled from a trauma registry: 574 received care before ACA implementation and 6964 after ACA implementation.

Before ACA implementation, 43% of patients were covered by Medicare or Medicaid and 22.5% were uninsured, researchers reported. After the ACA, 66% were covered by Medicare or Medicaid and 5.3% were uninsured.

After adjusting for factors including age, medical history, and injury severity, Medicare or Medicaid coverage was associated with lower odds of mortality after the ACA (0.7) compared with pre-ACA (4.1), the study found. However, being uninsured was linked with higher odds of mortality after the ACA (9.4) compared with before the ACA (0.9).

“Though there were significantly fewer uninsured patients post-ACA, this group had a notable increase in mortality and remains an important target for multidisciplinary interventions in the post-acute setting,” researchers advised.

 —Jolynn Tumolo

Reference:
Martin T, Hynes A, Kheirbek T. Association of payer status and mortality in trauma before and after the Affordable Care Act. J Am Coll Surg. 2020;231(4):e227-e228. doi:10.1016/j.jamcollsurg.2020.08.608

 

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