Introduction: Socioeconomic and racial disparities have been defined in trauma patients despite assumed equal access-to-care, yet little information exists on Asian patients. This study analyzes rates of mortality in Asian trauma patients while controlling for socioeconomic status.
Methods: From 2012-2015, 52,359 Asian patients presented to trauma centers and were registered with National Trauma Data Bank. Pearson Chi2 and multivariate logistic regression for mortality were run controlling for age, gender, co-morbidities, injury severity, insurance, race, and ethnicity. Negative binomial regression with margin commands for LOS was done for all patients and patients with polytrauma (ISS>15 n=14,787)
Results: Uninsured Asian patients were 1.8 times more likely to die than privately insured Asian patients (p<0.001). Medicare patients were 1.7 times more likely to die (p<0.001). 81 Asian patients identified themselves as Hispanic and there was no significant difference in their mortality or LOS for this group (p=0.06, p=0.18). Bleeding disorders, psychiatric history, diabetes, cirrhosis, hypertension, respiratory disease, cancer, esophageal varices, angina, CVA, and dependent healthcare prior to trauma all individually affected mortality and were controlled for in this model (p<0.05). Analysis of LOS for found Medicaid patients stay 1.7 days longer (2.2 polytrauma), workman’s compensation 1.1 days longer (2.1 polytrauma), while uninsured have shorter LOS (p<0.005). Males with polytrauma stayed 1.6 days longer than females (p<0.001) and age did not affect LOS for this group.
Conclusion: There are noteworthy socioeconomic disparities influencing Asian trauma patient outcomes. Mortality is significantly affected by insurance status despite controlling for age, ethnicity, injury severity, and comorbidities.
