Format

Send to

Choose Destination
J Racial Ethn Health Disparities. 2019 Apr;6(2):335-344. doi: 10.1007/s40615-018-0529-3. Epub 2018 Oct 1.

Differences in Injury Characteristics and Outcomes for American Indian/Alaska Native People Hospitalized with Traumatic Injuries: an Analysis of the National Trauma Data Bank.

Author information

1
Department of Rehabilitation Medicine, University of Washington, Seattle, WA, USA. molly.fuentes@seattlechildrens.org.
2
Harborview Injury Prevention and Research Center, Seattle, WA, USA. molly.fuentes@seattlechildrens.org.
3
Center for Child Health Behavior and Development, Seattle Children's Research Institute, Seattle, WA, USA. molly.fuentes@seattlechildrens.org.
4
Harborview Injury Prevention and Research Center, Seattle, WA, USA.
5
School of Social Work, University of Washington, Seattle, WA, USA.
6
Department of Environmental & Occupational Health, Drexel University, Philadelphia, PA, USA.
7
Urban Health Collaborative, Drexel University, Philadelphia, PA, USA.
8
Albuquerque Area Southwest Tribal Epidemiology Center, Albuquerque, NM, USA.
9
Department of Anesthesiology and Pain Medicine, University of Washington, Seattle, WA, USA.

Abstract

OBJECTIVE:

This study compares characteristics of American Indian/Alaska Natives (AI/AN) and non-Hispanic Whites (NHW) hospitalized for traumatic injury and examines the effect of race on hospital disposition.

METHODS:

Using 2007-2014 National Trauma Data Bank data, we described differences in demographic and injury characteristics between AI/AN (n = 39,656) and NHWs (n = 3,309,484) hospitalized with traumatic injuries. Multivariable regressions, adjusted for demographic and injury characteristics, compared in-hospital mortality and the risk of discharge to different dispositions (inpatient rehabilitation/long-term care facility, skilled nursing facility, home with home health services) rather than home between AI/AN and NHW patients.

RESULTS:

Compared to NHWs, a higher proportion of AI/ANs were age 19-44 (49% versus 27%) years and hospitalized with assault-related injuries (25% versus 5%). AI/ANs had lower odds of dying than NHWs during hospitalization (adjusted odds ratio (aOR) 0.72, 95% CI 0.63-0.84). However, AI/ANs also had lower odds than NHWs to discharge to locations with additional health services even after controlling for injury severity (inpatient rehabilitation/long-term care facilities aOR 0.79, 95% CI 0.67-0.93; skilled nursing facility aOR 0.70, 95% CI 0.49-0.98; home with home health services aOR 0.62, 95% CI 0.49-0.79).

CONCLUSIONS:

Injury patterns and acute hospitalization outcomes were significantly different for AI/ANs compared to NHWs. Injury prevention strategies targeting AI/ANs should reflect these differential injury patterns. Outcomes such as disability and access to rehabilitation services should be included when considering the burden of injury among AI/AN communities.

KEYWORDS:

Alaska Native; American Indian; Health care disparity; Hospitalization; Rehabilitation; Trauma

PMID:
30276637
PMCID:
PMC6424619
[Available on 2020-04-01]
DOI:
10.1007/s40615-018-0529-3

Supplemental Content

Loading ...
Support Center