A Population-Based Analysis of Socioeconomic Status and Insurance Status and Their Relationship With Pediatric Trauma Hospitalization and Mortality Rates
James P. Marcin, MD, MPH,
Michael S. Schembri, MS,
Jingsong He, MS and
Patrick S. Romano, MD, MPH
James P. Marcin is with the Department of Pediatrics and the Center for Health Services Research in Primary Care, University of California, Davis. Jingsong He and Michael S. Schembri are with the Center for Health Services Research in Primary Care. Patrick S. Romano is with the Division of General Internal Medicine, the Department of Pediatrics, and the Center for Health Services Research in Primary Care.
Correspondence: Requests for reprints should be sent to James P. Marcin, MD, MPH, Department of Pediatrics, Section of Critical Care Medicine, 2516 Stockton Blvd, Sacramento, CA 95817 (e-mail: jpmarcin{at}ucdavis.edu).
Objectives. We investigated socioeconomic disparities in injuryhospitalization rates and severity-adjusted mortality for pediatrictrauma.
Methods. We used 10 years of pediatric trauma data from SacramentoCounty, Calif, to compare trauma hospitalization rates, traumamechanism and severity, and standardized hospital mortalityacross socioeconomic strata (median household income, proportionof households in poverty, insurance).
Results. Children from lowersocioeconomic status (SES)communities had higher injury hospitalization and mortalityrates, and presented more frequently with more lethal mechanismsof injury (pedestrian, firearm), but did not have higher severity-adjustedmortality.
Conclusions. Higher injury mortality rates among children oflower SES in Sacramento County are explained by a higher incidenceof trauma and more fatal mechanisms of injury, not by greaterinjury severity or poorer inpatient care.
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