Critically injured trauma patients without insurance had a higher risk of being taken off life-saving care sooner than their insured counterparts, according to findings from a retrospective cohort study of more than 300,000 U.S. adults.

After adjustment for patient and hospital characteristics, those without insurance had significantly earlier withdrawal of life-sustaining therapy (WLST) when compared with Medicaid recipients (HR 1.53, 95% CI 1.45-1.62) or the privately insured (HR 1.57, 95% CI 1.49-1.65), reported researchers led by Graeme Hoit, MD, of the University of Toronto.

In contrast, no such difference in time to WLST was observed between the Medicaid and privately insured groups (HR 1.03, 95% CI 0.98-1.08). Unadjusted numbers showed mean times to WLST of 6.5 days in the uninsured group, 8.9 days in the Medicaid group, and 7.8 days for the privately insured group.

“Our study suggests that a patient’s ability to pay may be associated with a shift in decision-making for WLST,” the group wrote in JAMA Network Open

This would appear to go […]