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Trauma: Live or die? White vs "minority" trauma center may determine your outcome

Study conclusion: Patients treated at hospitals with higher proportions of minority trauma patients have increased odds of dying, even after adjusting for potential confounders.



“Trauma patients have a better chance of survival if they receive care at a trauma center in a hospital that treats primarily non-minority patients versus being treated in a hospital that provides care to primarily minority patients.”

-source



This is surprising because it would seem that hospitals that deal with more trauma would be in large city centers with more crime, and more traffic.  Large, city-center hospitals tend to have many training residency programs which means that access to specialists is readily available (even IF they are trainees, they are more prepared treat the specific injury patterns unique to their specialty than a physician who doesn’t typically deal with such problems).  And they have mechanisms in place, protocols, processes, and equipment to deal with high volume trauma that may be lacking in smaller, more suburban hospitals.



However, it was discovered that patients (of all races) were 45% more likely to die in minority hospitals with blunt trauma injuries, and 37% more likely to die of traumatic injuries overall when compared with white hospitals.



So this means that even if a white person went to a minority hospital, their likelihood of death would be higher.  Likewise, if a minority patient went to a white hospital, their mortality is lower.  This information condemns minority hospitals, which seem to save less people, no matter who they are, in trauma.



The researchers speculate that this might be due to funding issues, and the fact that minority hospitals have a larger payer mix of uninsured patients.  Specifically, white hospitals had about 75% of it’s patients with insurance, whereas minority hospitals had just over half at 55%.



"Minorities and the uninsured were more likely to die of trauma injury," stated Haider.



Seems to me that, if this is the problem, it could be alleviated if everyone had insurance.  That way, all hospitals will have a more consistent payer mix, and those hospitals that see more patients, will have more money available in which to treat those patients appropriately.  Sometimes people “forget” that healthcare indeed is NOT free.  And without adequate funds, things don’t work well.