2020
Urgent Care Centers Delay Emergent Surgical Care Based on Patient Insurance Status in The United States.
Hsiang WR, Wiznia D, Yousman L, Najem M, Mosier-Mills A, Jin G, Jain S, Khunte A, Davis KA, Forman HP, Schuster KM. Urgent Care Centers Delay Emergent Surgical Care Based on Patient Insurance Status in The United States. Annals Of Surgery 2020, 272: 548-553. PMID: 32932304, DOI: 10.1097/sla.0000000000004373.Peer-Reviewed Original ResearchMeSH KeywordsAmbulatory Care FacilitiesEmergency TreatmentHumansInsurance CoverageMedicaidSurgical Procedures, OperativeTime-to-TreatmentUnited StatesConceptsUrgent care centersMedicaid patientsCare centerInsurance typePrivate patientsEmergent surgical careEmergent surgical casesUrgent surgical conditionIncarcerated inguinal herniaEmergency department referralsPatient insurance statusED referralsInsurance statusReferral ratesInguinal herniaSurgical conditionsSurgical careSurgical casesPatientsPrivate insuranceCliniciansStandardized scriptMedicaidCareEmergent conditions
2018
Racial/Ethnic Disparities in Longer-term Outcomes Among Emergency General Surgery Patients
Zogg CK, Jiang W, Ottesen TD, Shafi S, Schuster K, Becher R, Davis KA, Haider AH. Racial/Ethnic Disparities in Longer-term Outcomes Among Emergency General Surgery Patients. Annals Of Surgery 2018, 268: 968-979. PMID: 28742704, PMCID: PMC5783796, DOI: 10.1097/sla.0000000000002449.Peer-Reviewed Original ResearchConceptsEmergency general surgery patientsNon-Hispanic whitesGeneral surgery patientsLong-term outcomesNon-Hispanic blacksNon-Hispanic AsiansMinority patientsMajor morbidityUnplanned readmissionSurgery patientsOlder adultsRisk-adjusted Cox proportional hazards modelsEthnic disparitiesCox proportional hazards modelDiagnostic categoriesRacial/Ethnic DisparitiesUS population agesProportional hazards modelNHB patientsNonagenarian patientsNHW patientsBACKGROUND DATAHospital's percentageMortality differencesMedicare dataImpact of Affordable Care Act Insurance Expansion on Pre-Hospital Access to Care: Changes in Adult Perforated Appendix Admission Rates after Medicaid Expansion and the Dependent Coverage Provision
Zogg CK, Scott JW, Bhulani N, Gluck AR, Curfman GD, Davis KA, Dimick JB, Haider AH. Impact of Affordable Care Act Insurance Expansion on Pre-Hospital Access to Care: Changes in Adult Perforated Appendix Admission Rates after Medicaid Expansion and the Dependent Coverage Provision. Journal Of The American College Of Surgeons 2018, 228: 29-43.e1. PMID: 30359835, DOI: 10.1016/j.jamcollsurg.2018.09.022.Peer-Reviewed Original ResearchConceptsMedicaid expansionAffordable Care ActAdmission ratesPerforation rateInsurance coverageAffordable Care Act's insurance expansionInsurance expansionYoung adultsAcute surgical careDependent coverage provisionBetter patient outcomesFederal poverty levelRace/ethnicityAcute appendicitisHospitalized adultsAcute careParents' insuranceInpatient claimsPatient outcomesACA's impactSurgical careRisk populationsNonexpansion statesPrivileged patientsAge 26Opioid dependency is independently associated with inferior clinical outcomes after trauma
Hsiang WR, McGeoch C, Lee S, Cheung W, Becher R, Davis KA, Schuster K. Opioid dependency is independently associated with inferior clinical outcomes after trauma. Injury 2018, 50: 192-196. PMID: 30342762, DOI: 10.1016/j.injury.2018.10.015.Peer-Reviewed Original ResearchConceptsNon-home dischargeOpioid-dependent patientsLength of stayInjury Severity ScoreOpioid dependencyVentilator daysMajor complicationsClinical outcomesPrescription abuseIllicit abuseLonger LOSChronic pain subgroupsMore ventilator daysOpioid-naïve patientsUse of opioidsAcademic Level IHigher readmission ratesInferior clinical outcomesChronic pain patientsOpioid subgroupsNaïve patientsAdult patientsPain subgroupsPatient demographicsReadmission ratesInsurance Status Biases Trauma-system Utilization and Appropriate Interfacility Transfer
Zogg CK, Schuster KM, Maung AA, Davis KA. Insurance Status Biases Trauma-system Utilization and Appropriate Interfacility Transfer. Annals Of Surgery 2018, 268: 681-689. PMID: 30004929, DOI: 10.1097/sla.0000000000002954.Peer-Reviewed Original ResearchConceptsNTC patientsMajor injuriesOlder adult trauma patientsNationwide Emergency Department SampleOptimal trauma careAdult trauma patientsEmergency department admissionsEmergency Department SampleTrauma center careTransfer of patientsComplex traumatic injuriesMultilevel logistic regressionTrauma patientsDepartment admissionsHigh morbidityTC careDirect admissionInsurance statusInterfacility transferUninsured patientsTrauma careTraumatic injuryOutcome measuresTrauma systemCenter careThe effect of insurance type on access to inguinal hernia repair under the Affordable Care Act
Hsiang W, McGeoch C, Lee S, Cheung W, Becher R, Davis KA, Schuster KM. The effect of insurance type on access to inguinal hernia repair under the Affordable Care Act. Surgery 2018, 164: 201-205. PMID: 29747862, DOI: 10.1016/j.surg.2018.03.013.Peer-Reviewed Original Research