The Pennsylvania research team used the 2009 Nationwide Emergency Department Sample to analyze 19,312 encounters involving adult major trauma patients under age 65 in 636 non-trauma center emergency departments whether they were admitted or transferred.
Compared with patients who were uninsured, those who were covered by Medicaid had a rate of admission vs. transfer that was 14.3% higher, the researchers found. Medicare patients were 13.2% more likely to be admitted than transferred, privately insured patients were 11.2% more likely to be admitted and patients with other commercial insurance 13.1% to be admitted to the non-trauma hospital.
Questions About the Study
In an accompanying invited commentary, "Does a Wallet Biopsy Lead to Inappropriate Trauma Patient Care?" Charles Mabry, MD, of the University of Arkansas for Medical Sciences Department of Surgery in Little Rock, raised several concerns about the Penn report:
Lastly, he wrote, with more emergency room physicians becoming hospital employees, "it will be interesting to se if that change in compensation will have any influence on the decisions to admit or transfer."