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Upper Extremity Injuries Seen at a Level 1 Trauma Center

Does Insurance Status Matter?

Wenzinger, Eric BS*†; Singh, Robinder MD*†; Herrera, Fernando MD*†

doi: 10.1097/SAP.0000000000001273
Hand Surgery
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Background Hand and upper extremity injuries are one of the leading causes of injury in the United States, making up 10% of all emergency department visits. The purpose of this study was to determine if there are any demographic differences between patients presenting primarily to our emergency department for upper extremity injuries versus those transferred from outside hospitals for the same diagnoses.

Methods A retrospective review of our hand trauma database was performed between 2011 and 2014. All patients within this period with International Classification of Disease 9 codes consistent with upper extremity injuries were included in this study. Patients were stratified into 2 groups: those who first presented to another hospital and accepted as transfers to our institution (group 1) and those presenting directly to our emergency department (group 2). Demographic data were collected for each group including sex, age, race, insurance status, mechanism, need for emergent surgery, and day and time of presentation. The groups were analyzed using odds ratios with a 95% confidence interval and paired t test for continuous variables.

Results One hundred thirty-nine patients with isolated upper extremity injuries were accepted for transfer from an outside hospital, and 419 patients presented directly to our institution. The average age of group 1 was 38 (77% M, 23% F) compared with 41 (73% M, 27% F) for group 2. Forty percent of group 1 patients were uninsured compared with 17% for group 2. There was a significant difference between groups (P < 0.05).

Conclusions The data suggest that our institution receives a large proportion of uninsured patients transferred for emergent upper extremity care compared with our current patient demographic. Because this is a retrospective study, the precise reason for these discrepancies will remain unknown.

From the *Medical University of South Carolina and †Ralph H. Johnson Veterans Medical Center, Charleston, SC.

Received July 22, 2017, and accepted for publication, after revision September 8, 2017.

Conflicts of interest and sources of funding: none declared.

Reprints: Fernando A. Herrera, MD, Medical University of South Carolina, 96 Jonathan Lucas St, Charleston, SC 29425. E-mail: herreraf@musc.edu.

This work was presented at the American Society of Plastic Surgery, Los Angeles, Calif, September 2017.

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