Disparities in disposition from trauma centers to inpatient psychiatric treatment in a national sample of patients with self-inflicted injury. Surgery 2023 Mar;173(3):799-803
Date
11/11/2022Pubmed ID
36357230DOI
10.1016/j.surg.2022.09.030Scopus ID
2-s2.0-85142720802 (requires institutional sign-in at Scopus site)Abstract
BACKGROUND: Surgery providers are integral to the treatment of patients with self-inflicted injuries. Patient disposition (eg, home, inpatient psychiatric treatment, rehabilitation) is important to long-term outcomes, but little is known about factors influencing disposition after discharge following traumatic self-inflicted injury. We tested whether patient or injury characteristics were associated with disposition after treatment for self-inflicted injury.
METHODS: National Trauma Data Bank query for self-inflicted injuries from 2010 to 2018.
RESULTS: There were 77,731 patients treated for self-inflicted injuries during the study period. Discharge home was the most common disposition (45%), and those without insurance were less likely to discharge to inpatient psychiatric treatment than those with insurance. Racial minority patients were less likely to discharge to inpatient psychiatric treatment (18.9%) than nonminority patients (23.8%, P < .001). Additionally, patients discharged to inpatient psychiatric treatment had significantly lower injury severity score (7.24 ± 7.5) than those who did not (8.69 ± 9.1, P < .001).
CONCLUSION: Racial/ethnic minority patients and those without insurance were significantly less likely to discharge to an inpatient psychiatric facility after treatment at a trauma center for self-inflicted injury. Future research is needed to evaluate the internal factors (eg, trauma center practices) and external factors (eg, inpatient psychiatric facilities not accepting patients with wound care needs) driving disposition variability.
Author List
Schramm AT, Libby Schroeder ME, Brandolino AM, Kant JM, Kohlbeck SA, Bergner C, Milia DJ, deRoon-Cassini TAAuthors
Carisa Bergner Biostatistician II in the Surgery department at Medical College of WisconsinAmber Brandolino in the CTSI department at Medical College of Wisconsin - CTSI
Sara Kohlbeck PhD, MPH Assistant Professor in the Psychiatry and Behavioral Medicine department at Medical College of Wisconsin
David J. Milia MD Professor in the Surgery department at Medical College of Wisconsin
Andrew T. Schramm PhD Assistant Professor in the Surgery department at Medical College of Wisconsin
Terri A. deRoon Cassini PhD Center Director, Professor in the Surgery department at Medical College of Wisconsin
MESH terms used to index this publication - Major topics in bold
HospitalizationHumans
Inpatients
Minority Groups
Patient Discharge
Retrospective Studies
Self Mutilation
Trauma Centers
