The impact of injury severity and transfer status on reimbursement for care of femur fractures

Nahm, Nickolas J.; Patterson, Brendan M.; Vallier, Heather A.

doi:10.1097/ta.0b013e31825a7723

Cited by 19 publications

(18 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Higher severity is associated with less underreporting, and there are fewer barriers to determining causality for trauma compared with chronic injuries or illnesses [Morse et al, 2000;Shannon and Lowe, 2002]. A recent study at a Level I trauma center also found that higher severity patients were more likely to have an identified payer [Nahm et al, 2012]. However, we did observe a differential with respect to payer.…”

Section: Discussioncontrasting

confidence: 68%

“…The mechanism is unknown, but could be related to hospitals being more highly motivated to identify all potential payers for more severe (and presumably more costly) injuries. A recent study at a Level I trauma center also found that higher severity patients were more likely to have an identified payer [Nahm et al, 2012]. In Washington State, the covered population does not include federal employees or exempt/excluded employment [State of Washington, 2012].…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Who Pays for Work‐Related Traumatic Injuries? Payer Distribution in Washington State by Ethnicity, Injury Severity, and Year (1998–2008)

Sears

Bowman

Adams

et al. 2013

American J Industrial Med

View full text Add to dashboard Cite

This study demonstrated the importance of considering differential access to other insurance coverage and adaptation by health care settings to financial pressures when assessing trends in occupational injury incidence and reporting, especially when using WC as a proxy for work-relatedness. The addition of occupation, industry, and work status to trauma registries and hospital discharge databases would improve surveillance, research, policy and prevention efforts.

show abstract

Section: Discussioncontrasting

confidence: 68%

Section: Discussionmentioning

confidence: 99%

Who Pays for Work‐Related Traumatic Injuries? Payer Distribution in Washington State by Ethnicity, Injury Severity, and Year (1998–2008)

Sears

Bowman

Adams

et al. 2013

American J Industrial Med

View full text Add to dashboard Cite

show abstract

“…This comports with previous findings from Washington State (Sears et al. ) and Ohio (Nahm, Patterson, and Vallier ). This pattern could be related to hospitals being more highly motivated to identify all potential payers for more severe (and presumably more costly) injuries.…”

Section: Discussionsupporting

confidence: 92%

Industrial Injury Hospitalizations Billed to Payers Other Than Workers' Compensation: Characteristics and Trends by State

Sears

Bowman

Blanar

et al. 2016

Health Services Research

View full text Add to dashboard Cite

show abstract

“…While in some cases accepting transfer patients results in a greater proportion of patients without insurance or with Medicaid,[9, 10] in other cases inter-hospital transfer does not alter or even improves a facility's payer mix. [11, 21, 22]…”

Section: Discussionmentioning

confidence: 99%

Insurance status influences emergent designation in surgical transfers

Broman

Phillips

Hayes

et al. 2016

Journal of Surgical Research

View full text Add to dashboard Cite

Background There is a perception among surgeons that hospitals disproportionately transfer unfavorably insured patients for emergency surgical care. Emergency Medical Condition (EMC) designation mandates referral center acceptance of patients for whom transfer is requested. We sought to understand whether unfavorably insured patients are more likely to be designated as EMCs. Materials and Methods A retrospective cohort study was performed of patient transfers from a large network of acute care facilities to emergency surgery services at a tertiary referral center from 2009-2013. Insurance was categorized as favorable (commercial or Medicare) or unfavorable (Medicaid or uninsured). The primary outcome, transfer designation as EMC or non-EMC, was evaluated using multivariable logistic regression. A secondary analysis evaluated uninsured patients only. Results There were 1,295 patient transfers in the study period. Twenty percent had unfavorable insurance. Favorably insured patients were older with fewer non-white, more comorbidities, greater illness severity, and more likely transferred for care continuity. More unfavorably insured patients were designated as EMCs (90% vs 84%, p<0.01). In adjusted models, there was no association between unfavorable insurance and EMC transfer (OR 1.61, 0.98-2.69). Uninsured patients were more likely to be designated as EMCs (OR 2.27, 1.08-4.77) Conclusions The finding that uninsured patients were more likely to be designated as EMCs suggests non-clinical variation that may be mitigated by clearer definitions and increased inter-facility coordination to identify patients requiring transfer for emergency medical conditions.

show abstract

The impact of injury severity and transfer status on reimbursement for care of femur fractures

Abstract: Prognostic/epidemiologic study, level III. Economic analysis, level IV.

Cited by 19 publications

References 25 publications

Who Pays for Work‐Related Traumatic Injuries? Payer Distribution in Washington State by Ethnicity, Injury Severity, and Year (1998–2008)

Who Pays for Work‐Related Traumatic Injuries? Payer Distribution in Washington State by Ethnicity, Injury Severity, and Year (1998–2008)

Industrial Injury Hospitalizations Billed to Payers Other Than Workers' Compensation: Characteristics and Trends by State

Insurance status influences emergent designation in surgical transfers

Contact Info

Product

Resources

About