Abstract
BackgroundInjury is second only to cardiovascular disease in terms of acute care costs in North America. One key to improving injury care efficiency is to generate knowledge on the determinants of resource use. Socio-economic status (SES) is a documented risk factor for injury severity and mortality but its impact on length of stay (LOS) for injury admissions is unknown. This study aimed to examine the relationship between SES and LOS following injury.This multicenter retrospective cohort study was based on adults discharged alive from any trauma center (2007–2012; 57 hospitals; 65,486 patients) in a Canadian integrated provincial trauma system. SES was determined using ecological indices of material and social deprivation. Mean differences in LOS adjusted for age, gender, comorbidities, and injury severity were generated using multivariate linear regression.ResultsMean LOS was 13.5 days. Patients in the highest quintile of material/social deprivation had a mean LOS 0.5 days (95 % CI 0.1-0.9)/1.4 days (1.1-1.8) longer than those in the lowest quintile. Patients in the highest quintiles of both social and material deprivation had a mean LOS 2.6 days (1.8-3.5) longer than those in the lowest quintiles.ConclusionsResults suggest that patients admitted for traumatic injury who suffer from high social and/or material deprivation have longer acute care LOS in a universal-access health care system. The reasons behind observed differences need to be further explored but may indicate that discharge planning should take patient SES into consideration.
Highlights
Injury is second only to cardiovascular disease in terms of acute care costs in North America
A deprivation index couldn’t be assigned to 2686 patients (3.7 %) due to a missing or invalid postal code and to 3837 patients (5.3 %) because no Socio-economic status (SES) information was available for their residential zone [19]
Social deprivation increased with age and was more prevalent in patients with multiple comorbidities whereas material deprivation was lower for elderly patients (Table 1)
Summary
Injury is second only to cardiovascular disease in terms of acute care costs in North America. Socio-economic status (SES) is a documented risk factor for injury severity and mortality but its impact on length of stay (LOS) for injury admissions is unknown. This study aimed to examine the relationship between SES and LOS following injury This multicenter retrospective cohort study was based on adults discharged alive from any trauma center (2007–2012; 57 hospitals; 65,486 patients) in a Canadian integrated provincial trauma system. Low SES has been consistently documented as a risk factor for injury-related mortality, injury hospitalizations, Moore et al BMC Health Services Research (2015) 15:285 and injury severity [16]. Compared to chronic disease populations, injury admissions represent younger patients with fewer comorbidities, different discharge patterns and specific socio-economic issues [17]. In order to improve the quality and efficiency of acute injury care, we need to improve our understanding of the influence of SES on LOS for injury admissions
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
