• Heather Peluso, Marwan S Abougergi, and Julie Caffrey.
• Department of surgery, University of South Carolina, Greenville Health System, 701 Grove Road, Greenville, SC, 29605, USA. Electronic address: hpeluso@ghs.org.
• Burns. 2018 Dec 1; 44 (8): 1973-1981.

ObjectiveTo study the relationship between insurance provider and important outcomes among patients with burn injury.MethodsAdults with burn injury were selected from the National Inpatient Sample. The primary outcome was inpatient mortality. Secondary outcomes were morbidity (septic shock and prolonged mechanical ventilation (PMV)), treatment metrics (time to surgery and parenteral or enteral nutrition (P/E-nutrition)) and resource utilization (length of stay (LOS) and total hospitalization costs and charges). Confounders were adjusted for using multivariate regression analysis.ResultsInsurance did not affect in-hospital mortality rate. Compared with private insurance, Medicaid was associated with higher septic shock rate (aOR: 2.14 (1.04-4.39), longer LOS (adjusted mean difference (aMD): 2.79 (0.50-5.08) days) and higher costs (aMD: $16,161 ($4789-$27,534) while uninsured patients has shorter LOS (aMD: -2.57 (-4.59--0.55) days), lower charges (aMD: $-37,792 $(-65,550-$-10,034) and costs (aMD: $-8563 ($15,581-$-1544)). Insurance did not affect PMV rates or time to surgery or P/E-nutrition.ConclusionsPrimary payer does not affect in-hospital mortality or treatment metrics among patients admitted for burn injury. However, compared with private insurance, Medicaid was associated with both higher morbidity and resource utilization, whereas uninsured patients had lower resource utilization.Crown Copyright © 2018. Published by Elsevier Ltd. All rights reserved.

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