Insurance status and health-related quality-of-life disparities after trauma: results from a nationally representative survey in the US

Suliman Alghnam, Eric B Schneider, Renan C Castillo
Quality of Life Research 2016, 25 (4): 987-95

PURPOSE: To determine whether insurance status modifies the association between injuries and health-related quality of life (HRQOL) in a nationally representative sample of US adults.

METHODS: This is a longitudinal, observational study using the pooled 2000-2006 Medical Expenditure Panel Survey (MEPS). A total of 50,225 adults (age ≥ 18) with or without injuries were included in the study. HRQOL was evaluated using the EuroQoL Health Index (EQ-5D), visual analog scale (VAS), and the SF-12 physical component score (PCS) and mental component score (MCS). A categorical variable of injury-insurance combinations was created (not injured-privately insured, not injured-publically insured, not injured-uninsured, injured-privately insured, injured-publically insured, or injured-uninsured) and was included in the linear regression models. Adjustment covariates included age, gender, education, race, diabetes, hypertension, and baseline self-reported health. Healthcare utilization was also examined among the study population by injury status and across insurance groups.

RESULTS: Seven hundred and ten individuals reported injuries. Adjusted analyses showed that injured individuals with public insurance had lower EQ-5D (-0.25), VAS (-11.4), PCS (-8.5), and MCS (-4.9) than the privately insured controls, while uninsured had EQ-5D, VAS, PCS and MCS that were, respectively, -0.12, -7.2, -2.6 and -4.1 relative to privately insured controls. With the exception of hospital discharges, healthcare utilization among uninsured individuals was lower than those with public or private insurance.

CONCLUSIONS: We found injured individuals to have lower HRQOL than those without injuries, and this effect was exacerbated by insurance status. These findings call for interventions aimed to narrow the outcome disparity among injured in the US.


You are not logged in. Sign Up or Log In to join the discussion.

Trending Papers

Available on the App Store

Available on the Play Store
Remove bar
Read by QxMD icon Read

Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"