Introduction: Previous studies have shown that disparities in treatment exist in the US. Our goal was to determine if disparities in surgical versus nonsurgical treatment, exist by race, sex, age, and insurance coverage for... [ view full abstract ]
Introduction: Previous studies have shown that disparities in treatment exist in the US. Our goal was to determine if disparities in surgical versus nonsurgical treatment, exist by race, sex, age, and insurance coverage for patients treated for facial fractures at a level 1 trauma center in the southern US.
Methods: Patients with facial fractures at a level 1 trauma center from 2010-2014 were identified using the trauma registry. ICD-9 codes were used to identify patients with facial fractures and which patients underwent surgical repair. Patient demographic information, injury characteristics, and clinical data were compared.
Results: There were 2267 patients with facial fractures, 473 who underwent surgery. There was a significant difference in age between those undergoing surgery versus no surgery (p=0.0088). Those undergoing surgery had significantly longer length of stay (p<0.0001), days in the ICU (p<0.0001), and higher facial abbreviated injury score (p<0.0001). There were no differences in surgical status by sex (p=0.6264), race (p=0.8602), payment type (p=0.5044), or injury severity score (p=0.0528). Those undergoing surgical procedures waited longer to seek care (p=0.0069). Time to surgery was slightly longer for females (p=0.0643) and for whites (p=0.0556).
Conclusion: This data does not support previous studies’ findings of disparities in treatment based on race and insurance status. This may be attributable to the diversity of this trauma center’s patient population and staff and possibly a higher level of cultural competency in treatment. Further investigations utilizing a multicenter, nationwide database should be performed to verify and validate these results.
