Data resources for evaluating the economic and financial consequences of surgical care in the United States

Scott, John W.; Ayoung-Chee, Patricia; Lester, Erica L W; Bruns, Brandon R.; Davis, Kimberly A.; Gore, Amy V.; Knowlton, Lisa Marie; Liu, Charles; Martin, Robert; Oh, Esther J; Ross, Samuel W.; Wandling, Michael W.; Minei, Joseph P.; Staudenmayer, Kristan

doi:10.1097/ta.0000000000003631

Cited by 2 publications

(15 citation statements)

References 88 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…It was able to identify four different financial trajectories after injury, including financially secure, financially frail, financially resilient, and financially devastated 23 . Noting the recovery and exacerbation patterns of FT and outcomes in these distinct trajectories, our findings on FT and health outcomes at a single time-point depict similar relationships and contribute further evidence supporting the bidirectional relationship of long-term health outcomes and FT for these patients 1,6 …”

Section: Discussionsupporting

confidence: 66%

“…This is compared with a similar study by Murphy et al 1 that sought to capture both objective and subjective components of FT; they found an FT prevalence of nearly 88% in their moderate to severely injured trauma patients in Memphis. Since people may experience financial hardship with only subjective measures, 6 our study may underestimate the prevalence of FT in our population.…”

Section: Discussionmentioning

confidence: 92%

“…Trauma patients are disproportionately uninsured and more likely to be economically and socially disadvantaged, and the trauma often leads to difficulty finding employment or returning to work. Finally, unlike conditions, such as cancer, the nature of trauma allows no time for planning or adaptation 6 . This issue is growing in significance as trauma centers achieve higher survival rates and the landscape of trauma care is beginning to shift from acute interventions to the ongoing management of chronic conditions 6,7 …”

mentioning

confidence: 99%

“…Finally, unlike conditions, such as cancer, the nature of trauma allows no time for planning or adaptation. 6 This issue is growing in significance as trauma centers achieve higher survival rates and the landscape of trauma care is beginning to shift from acute interventions to the ongoing management of chronic conditions. 6,7 Despite its significance, FT remains challenging to measure and is poorly captured among trauma survivors.…”

mentioning

confidence: 99%

“…6 This issue is growing in significance as trauma centers achieve higher survival rates and the landscape of trauma care is beginning to shift from acute interventions to the ongoing management of chronic conditions. 6,7 Despite its significance, FT remains challenging to measure and is poorly captured among trauma survivors. Much of the existing literature has focused on payments for inpatient admission, with only a few touching upon the broader indirect consequences, such as return to work, income changes, new reliance on government assistance programs, nonmedical debt held on credit, and the consequences of affordability issues resulting in postponed or avoided healthcare.…”

mentioning

confidence: 99%

See 4 more Smart Citations

The invisible scars: Unseen financial complications worsen every aspect of long-term health in trauma survivors

Ilkhani,

Naus,

Pinkes

et al. 2024

J Trauma Acute Care Surg

View full text Add to dashboard Cite

Introduction Trauma survivors are susceptible to experiencing financial toxicity (FT). Studies have shown the negative impact of FT on chronic illness outcomes. However, there is a notable lack of data on FT in the context of trauma. We aimed to better understand prevalence, risk factors, and impact of FT on trauma long-term outcomes. Methods Adult trauma patients with an Injury severity score (ISS) ≥9 treated at level-1 trauma centers were interviewed 6–14 months after discharge. FT was considered positive if patients reported any of the following due to the injury: income loss, lack of care, newly applied/qualified for governmental assistance, new financial problems, or work loss. The Impact of FT on Patient Reported Outcome Measure Index System (PROMIS) health domains was investigated. Results Of 577 total patients, 44% (254/567) suffered some form of FT. In the adjusted model, older age (OR 0.4 [95% CI: 0.2 – 0.81]) and stronger social support networks (OR 0.44 [ 95% CI: 0.26 – 0.74]) were protective against FT. In contrast, having two or more comorbidities (OR 1.81 [1.01 – 3.28), lower education levels (OR = 1.95, [CI 95%: 1.26 – 3.03]), and injury mechanisms, including road accidents (OR 2.69 [1.51 -4.77]) and intentional injuries (OR 4.31 [1.44 -12.86]) were associated with higher toxicity. No significant relationship was found with ISS, sex, or single-family household. Patients with FT had worse outcomes across all domains of health. There was a negative linear relationship between the severity of FT and worse mental and physical health scores. Conclusion FT is associated with long-term outcomes. Incorporating FT risk assessment into recovery care planning may help to identify patients most in need of mitigative interventions across the trauma care continuum to improve trauma recovery. Further investigations to better understand, define, and address FT in trauma care are warranted. Level of Evidence Prognostic cohort study, level III

show abstract

Section: Discussionsupporting

confidence: 66%

Section: Discussionmentioning

confidence: 92%

mentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

See 3 more Smart Citations

The invisible scars: Unseen financial complications worsen every aspect of long-term health in trauma survivors

Ilkhani,

Naus,

Pinkes

et al. 2024

J Trauma Acute Care Surg

View full text Add to dashboard Cite

show abstract

Financial toxicity part II: A practical guide to measuring and tracking long-term financial outcomes among acute care surgery patients

Knowlton,

Scott,

Dowzicky

et al. 2024

J Trauma Acute Care Surg

View full text Add to dashboard Cite

Acute care surgery (ACS) patients are frequently faced with significant long-term recovery and financial implications that extend far beyond their hospitalization. While major injury and emergency general surgery (EGS) emergencies are often viewed solely as acute moments of crisis, the impact on patients can be lifelong. Financial outcomes after major injury or emergency surgery have only begun to be understood. The Healthcare Economics Committee from the American Association for the Surgery of Trauma (AAST) previously published a conceptual overview of financial toxicity in acute care surgery, highlighting the association between financial outcomes and long-term physical recovery. The aims of second phase financial toxicity review by the Healthcare Economics Committee of the AAST are to (i) understand the unique impact of financial toxicity on acute care surgery patients; (ii) delineate the current limitations surrounding measurement domains of financial toxicity in ACS; (iii) explore the “when, what and how” of optimally capturing financial outcomes in ACS; and (iv) delineate next steps for integration of these financial metrics in our long-term patient outcomes. As acute care surgeons, our patients’ recovery is often contingent on equal parts physical, emotional and financial recovery. The ACS community has an opportunity to impact long-term patient outcomes and well-being far beyond clinical recovery.

show abstract

Data resources for evaluating the economic and financial consequences of surgical care in the United States

Abstract: Wanting to perform surgically-relevant health economics and health policy research, but not sure where to start? This review covers policy-relevant databases along with strengths, weaknesses, and examples of each. High-quality policy research has never been more important.

Cited by 2 publications

References 88 publications

The invisible scars: Unseen financial complications worsen every aspect of long-term health in trauma survivors

The invisible scars: Unseen financial complications worsen every aspect of long-term health in trauma survivors

Financial toxicity part II: A practical guide to measuring and tracking long-term financial outcomes among acute care surgery patients

Contact Info

Product

Resources

About