Payer status and increased distance traveled for fracture care in a rural state

Journal of Orthopaedic Trauma
William D LackJ Lawrence Marsh

Abstract

To assess the volume and distance traveled for fracture care at a rural trauma center and how this varied over time by case type and by payer. A retrospective review of the electronic record. A rural level 1 trauma center. Adults presenting with operative orthopaedic trauma at a rural level 1 trauma center between 1990 and 2007. Not applicable. County of residence was used to calculate distances traveled to the tertiary care center. Case volume and distance traveled for care were compared by case type, early (1990-1997) and late (1998-2007) time periods, and by payer status. Injury severity score was compared by case type and time period. The presentation of simple injuries to the referral center increased throughout the study period without an increase in injury severity. The percentage of patients with simple injuries covered by standard Medicaid doubled from 11.8% to 21.2% between the early and late time periods. The average distance traveled by patients with simple injuries increased over time from 35.2 to 51 miles, and the distance was greater for Medicaid patients (59.7 vs 42.6 miles). Medicaid patients with emergent injuries also traveled farther for care (77.4 vs 66.1 miles). Increasing volume of orthopaedic trauma at a...Continue Reading

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Citations

Dec 6, 2019·Trauma Surgery & Acute Care Open·Joshua D JaramilloJoseph D Forrester

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