Patients with less complex fractures but no insurance were more likely than insured patients to be transferred to a Level I trauma center for definitive care, according to a study in the Journal of Orthopaedic Trauma.
The study compared fracture patients taken directly to the Level I center to those arriving by transfer from another hospital. Transferred patients were older and more often had commercial insurance. Many transfers were appropriate based on injury severity, such as acetabular and pelvic ring fractures.
However, uninsured patients with less complex fracture injuries were more likely to be transferred for higher-level trauma care. The mean ISS of uninsured transferred patients was 22.9, compared to a mean score of 25.8 for other patients. “[O]ver one-fourth of those transferred had low Injury Severity Score and a significantly higher incidence of no insurance,” the authors concluded. Read Abstract