2022
The extent to which geography explains one of trauma’s troubling trends: Insurance-based differences in appropriate interfacility transfer
Zogg CK, Schuster KM, Maung AA, Davis KA. The extent to which geography explains one of trauma’s troubling trends: Insurance-based differences in appropriate interfacility transfer. Journal Of Trauma And Acute Care Surgery 2022, 93: 686-694. PMID: 35293375, PMCID: PMC9470786, DOI: 10.1097/ta.0000000000003605.Peer-Reviewed Original ResearchMeSH KeywordsAdultGeographyHumansInsurance CoverageMedically UninsuredPatient TransferRetrospective StudiesTrauma CentersUnited StatesConceptsNontrauma centersEmergency departmentMajor injuriesTrauma centerSignificant geographic variationInsurance-based differencesRisk-adjusted oddsLarge trauma centersNeighborhood socioeconomic disadvantageHierarchical logistic regressionInsured adultsTransfer patientsInsurance statusInterfacility transferStratified analysisED claimsUninsured adultsLevel IIISecondary objectiveTriage patternsDeprived populationsLogistic regressionInjurySocioeconomic disadvantageAdmission differences
2019
Impact of Affordable Care Act–related insurance expansion policies on mortality and access to post-discharge care for trauma patients
Scott JW, Neiman PU, Uribe-Leitz T, Scott KW, Zogg CK, Salim A, Haider AH. Impact of Affordable Care Act–related insurance expansion policies on mortality and access to post-discharge care for trauma patients. Journal Of Trauma And Acute Care Surgery 2019, 86: 196-205. PMID: 30694984, DOI: 10.1097/ta.0000000000002117.Peer-Reviewed Original ResearchConceptsPost-discharge careTrauma patientsInpatient mortalityPost-acute careAffordable Care ActCoverage expansion policiesUninsured ratePost-acute care facilitiesState-level Medicaid expansionMedicaid expansionNational Trauma Data BankPolicy-associated changesAdult trauma patientsTrauma Data BankPost-acute servicesUninsured trauma patientsCare ActHome health servicesInsurance coverage expansionCoverage expansionPost-policy periodPatients 18Discharge dispositionPatient demographicsInjury characteristics
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 26Insurance 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 care
2017
The Need to Consider Longer-term Outcomes of Care
Zogg CK, Olufajo OA, Jiang W, Bystricky A, Scott JW, Shafi S, Havens JM, Salim A, Schoenfeld AJ, Haider AH. The Need to Consider Longer-term Outcomes of Care. Annals Of Surgery 2017, 266: 66-75. PMID: 28140382, DOI: 10.1097/sla.0000000000001932.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAgedBlack or African AmericanCaliforniaEmergency Service, HospitalHealthcare DisparitiesHispanic or LatinoHospital MortalityHumansIncomeInsurance CoverageInsurance, HealthLongitudinal StudiesMiddle AgedOutcome Assessment, Health CarePatient ReadmissionPostoperative ComplicationsProportional Hazards ModelsSurgical Procedures, OperativeSurvival AnalysisWhite PeopleYoung AdultConceptsLong-term outcomesNon-Hispanic blacksUnplanned readmissionMajor morbidityWhite patientsMinority patientsEthnic disparitiesEmergency general surgery patientsCalifornia State Inpatient DatabaseCox proportional hazards modelDiagnostic categoriesOlder adultsGeneral surgery patientsState Inpatient DatabasesProportional hazards modelRisk-adjusted differencesHispanic older adultsEGS patientsEGS volumeReadmission trendsSurgery patientsSurgical patientsHospital proportionInpatient DatabasePostacute phaseThe Association Between Medicare Eligibility and Gains in Access to Rehabilitative Care
Zogg CK, Scott JW, Metcalfe D, Seshadri AJ, Tsai TC, Davis WA, Rose JA, Olufajo OA, Zafar SN, Salim A, Haider AH. The Association Between Medicare Eligibility and Gains in Access to Rehabilitative Care. Annals Of Surgery 2017, 265: 734-742. PMID: 28267694, DOI: 10.1097/sla.0000000000001754.Peer-Reviewed Original ResearchMeSH KeywordsAdultAge FactorsAgedDatabases, FactualEligibility DeterminationFemaleHealth Care CostsHumansIncidenceInjury Severity ScoreInsurance CoverageMaleMedicareMiddle AgedNeeds AssessmentOutcome Assessment, Health CarePatient DischargePostoperative CareRehabilitation CentersRetrospective StudiesRisk AssessmentUnited StatesWounds and InjuriesConceptsSkilled nursing facilitiesAge 64Insurance statusNational Trauma Data BankMedicare eligibilityPost-discharge rehabilitationInsurance coverageAge 65 yearsTrauma Data BankLength of staySevere clinical presentationAcute inpatient facilitiesHealth policy changesTrauma patientsClinical presentationSimilar patientsDiagnosis codesStratified subgroupsInpatient careRehabilitative careTrauma systemAge 54SNF useInpatient facilitiesNursing facilities
2016
Implications of the Patient Protection and Affordable Care Act on Insurance Coverage and Rehabilitation Use Among Young Adult Trauma Patients.
Zogg CK, Payró Chew F, Scott JW, Wolf LL, Tsai TC, Najjar P, Olufajo OA, Schneider EB, Haut ER, Haider AH, Canner JK. Implications of the Patient Protection and Affordable Care Act on Insurance Coverage and Rehabilitation Use Among Young Adult Trauma Patients. JAMA Surgery 2016, 151: e163609. PMID: 27760245, DOI: 10.1001/jamasurg.2016.3609.Peer-Reviewed Original ResearchConceptsYoung adult trauma patientsDependent coverage provisionAdult trauma patientsAffordable Care ActTrauma patientsRehabilitation useInsurance coverageClinical end pointsPatient ProtectionCare ActCause of deathComplete patient recordsHigh-quality careEmergency departmentMean ageOutpatient settingUninsured patientsPatient outcomesRisk groupsPatientsRehabilitation accessACA implementationRescue ratesPatient recordsLongitudinal assessmentInsurance status is associated with complex presentation among emergency general surgery patients
Scott JW, Havens JM, Wolf LL, Zogg CK, Rose JA, Salim A, Haider AH. Insurance status is associated with complex presentation among emergency general surgery patients. Surgery 2016, 161: 320-328. PMID: 27712875, DOI: 10.1016/j.surg.2016.08.038.Peer-Reviewed Original ResearchMeSH KeywordsAdultDatabases, FactualEmergency Service, HospitalEmergency TreatmentFemaleGeneral SurgeryHealth Services AccessibilityHumansInsurance CoverageLogistic ModelsMaleMedically UninsuredMiddle AgedOdds RatioOutcome Assessment, Health CarePatient Protection and Affordable Care ActPatient SafetyRetrospective StudiesRisk AssessmentSocioeconomic FactorsUnited StatesYoung AdultConceptsInsurance statusComplex presentationSurgical presentationUninsured patientsEmergency general surgical careEmergency general surgical conditionsEmergency general surgical patientsEmergency general surgery patientsNational Emergency Department SampleHospital-level covariatesOverall uninsured rateUninsured payer statusGeneral surgery patientsGeneral surgical patientsGeneral surgical conditionsIntra-abdominal abscessMultivariable logistic regressionEmergency Department SampleDisease-specific measuresSeverity of diseaseLack of insuranceGeneral surgical careIntestinal gangreneBowel obstructionGeneralized peritonitisImpact of ACA Insurance Coverage Expansion on Perforated Appendix Rates Among Young Adults
Scott JW, Rose JA, Tsai TC, Zogg CK, Shrime MG, Sommers BD, Salim A, Haider AH. Impact of ACA Insurance Coverage Expansion on Perforated Appendix Rates Among Young Adults. Medical Care 2016, 54: 818-826. PMID: 27367865, PMCID: PMC5468100, DOI: 10.1097/mlr.0000000000000586.Peer-Reviewed Original ResearchConceptsDependent coverage provisionAppendix ratePerforation rateYoung adultsHealth insurance plansComparator groupAcute conditionsUninsured rateYear oldsParents' health insurance plansSignificant reductionNational Inpatient SampleUrban teaching hospitalAge 26 yearsHealth care accessInsurance coverage expansionDifferences linear regressionCoverage expansionAcute appendicitisAffordable Care ActInpatient SampleTeaching hospitalCare accessRisk subpopulationsPostpolicy changePredictors of emergency ventral hernia repair: Targets to improve patient access and guide patient selection for elective repair
Wolf LL, Scott JW, Zogg CK, Havens JM, Schneider EB, Smink DS, Salim A, Haider AH. Predictors of emergency ventral hernia repair: Targets to improve patient access and guide patient selection for elective repair. Surgery 2016, 160: 1379-1391. PMID: 27542434, DOI: 10.1016/j.surg.2016.06.027.Peer-Reviewed Original ResearchMeSH KeywordsAdultAge FactorsAgedAged, 80 and overConfidence IntervalsDatabases, FactualElective Surgical ProceduresEmergenciesFemaleFollow-Up StudiesHealth Services AccessibilityHernia, VentralHerniorrhaphyHospital MortalityHumansInsurance CoverageLogistic ModelsMaleMiddle AgedOdds RatioPatient SelectionPredictive Value of TestsQuality ImprovementRetrospective StudiesRisk AssessmentSeverity of Illness IndexSex FactorsTime FactorsTreatment OutcomeConceptsVentral hernia repairEmergency ventral hernia repairHospital-level factorsHernia repairIndependent predictorsPatient selectionElective operationsWorse outcomesEmergency repairLonger hospital stayNationwide Inpatient SampleMultivariable logistic regressionUnited States populationRace/ethnicityHospital deathHospital staySecondary outcomesElective repairPrimary outcomePayer statusInpatient SamplePatient outcomesVentral herniasElective careGreater oddsDifferential access to care: The role of age, insurance, and income on race/ethnicity-related disparities in adult perforated appendix admission rates
Zogg CK, Scott JW, Jiang W, Wolf LL, Haider AH. Differential access to care: The role of age, insurance, and income on race/ethnicity-related disparities in adult perforated appendix admission rates. Surgery 2016, 160: 1145-1154. PMID: 27486003, DOI: 10.1016/j.surg.2016.06.002.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultAge FactorsAppendicitisConfidence IntervalsEthnicityFemaleHealth Care SurveysHealth Services AccessibilityHealthcare DisparitiesHumansIncomeInsurance CoverageMaleMiddle AgedOdds RatioOutcome Assessment, Health CarePatient AdmissionRacial GroupsRisk AssessmentRoleUnited StatesYoung AdultConceptsAcute appendicitisAdmission ratesLack of differenceNationwide Inpatient SampleRisk-adjusted differencesUnited States populationRace/ethnicityPediatric studiesInpatient SampleWorse outcomesMinority patientsBetter outcomesUniversal insurancePatientsEthnic disparitiesLogistic regressionRole of ageEthnic inequitiesHealthcare ResearchAge incrementsOlder adultsAdultsDisparate outcomesEthnic differencesAppendicitisAssociation between Insurance Status and Hospital Length of Stay following Trauma
Englum BR, Hui X, Zogg CK, Chaudhary MA, Villegas C, Bolorunduro OB, Stevens KA, Haut ER, Cornwell EE, Efron DT, Haider AH. Association between Insurance Status and Hospital Length of Stay following Trauma. The American Surgeon 2016, 82: 281-288. PMID: 27099067, PMCID: PMC5142530, DOI: 10.1177/000313481608200324.Peer-Reviewed Original ResearchMeSH KeywordsAdolescentAdultFemaleHumansInsurance CoverageLength of StayMaleMiddle AgedWounds and InjuriesYoung AdultConceptsInsurance statusHospital lengthTrauma patientsUninsured patientsInjury severityNational Trauma Data BankAcute trauma patientsShorter hospital stayTrauma Data BankUninsured trauma patientsRisk-adjusted LOSMultivariable regression modelsQuality of careHealth care systemHospital LOSHospital stayDischarge dispositionClinical factorsNonclinical factorsTrauma populationSignificant confoundersBaseline differencesInclusion criteriaPatient's abilityClinical care