The Affordable Care Act and its association with length of stay and payer status for trauma patients at a level I trauma center

Vicente Jose Undurraga Perl, Chris Dodgion, Kyle Hart, Lyle (Bruce) Ham, Martin Schreiber, David Thomas Martin, David Zonies

Research output: Contribution to journalArticlepeer-review

8 Scopus citations

Abstract

Background We hypothesized that the ACA would shorten length of stay and increase numbers of insured patients without changing trauma patient outcomes. Methods A retrospective review of adult trauma patients admitted to a level I trauma center between 2012 and 2014 was performed. Demographics, length of stay, payer status, discharge disposition, and complications before and after the ACA implementation were analyzed. Results 4448 trauma patients were admitted during the study period. Patients treated after ACA implementation were older (53 vs 51, p = 0.05) with shorter ICU stays (1.7 vs 1.5 days, p = 0.04), but longer overall hospital stays (3.7 vs 4.1 days, p < 0.01). The proportion of self-pay patients decreased 11%–3% (p=<0.001). A higher proportion of patients were discharged to skilled nursing facilities (SNF, 17.1% vs 19.9%, p = 0.02). There was no change in rates of death, readmission, infection, pneumonia or decubiti. Conclusion Among trauma patients, there was a decrease in self-pay status and increase in public insurance without change in private insurance after implementation of the ACA. More patients were discharged to SNF without changes in reported outcomes.

Original languageEnglish (US)
Pages (from-to)870-873
Number of pages4
JournalAmerican Journal of Surgery
Volume213
Issue number5
DOIs
StatePublished - May 1 2017

Keywords

  • Affordable Care Act
  • Healthcare costs
  • Obamacare
  • Payer status

ASJC Scopus subject areas

  • Surgery

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