TRENDS IN DISPARITIES RESEARCH ON TRAUMA AND ACUTE CARE SURGERY OUTCOMES: A 10-YEAR SYSTEMATIC REVIEW OF ARTICLES PUBLISHED IN THE JOURNAL OF TRAUMA AND ACUTE CARE SURGERY.
Journal of Trauma and Acute Care Surgery
Racial disparities, gender inequalities, socioeconomic status, insurance status, trauma outcomes, diversity
This is a 10-year review of the Journal of Trauma and Acute Care Surgery (JTACS) literature related to healthcare disparities, healthcare inequities, and patient outcomes. A retrospective review of articles published in JTACS between January 1st, 2013, and July 15th, 2022, was performed. Articles screened included both adult and pediatric trauma populations. Included articles focused on patient populations related to trauma, surgical critical care, and emergency general surgery. Of the 4178 articles reviewed, 74 met the inclusion criteria. Health care disparities related to gender (n = 10), race/ethnicity (n = 12), age (n = 14), income status (n = 6), health literacy (n = 6), location and access to care (n = 23), and insurance status (n = 13) were described. Studies published on disparities peaked in 2016 and 2022 with 13 and 15 studies respectively but dropped to one study in 2017. Studies demonstrated a significant increase in mortality for patients in rural geographical regions and in patients without health insurance and a decrease in patients who were treated at a trauma center. Gender disparities resulted in variable mortality rates and studied factors including traumatic brain injury (TBI) mortality and severity, venous thromboembolism, ventilator-associated pneumonia, firearm homicide, and intimate partner violence. Under-represented race/ethnicity was associated with variable mortality rates, with 1 study demonstrating increased mortality risk and 3 finding no association between race/ethnicity and mortality. Disparities in health literacy resulted in decreased discharge compliance and worse long-term functional outcomes. Studies on disparities in JTACS over the last decade primarily focused on location and access to healthcare, age, insurance status, and race, with a specific emphasis on mortality. This review highlights the areas in need of further research and funding in the Journal of Trauma and Acute Care Surgery regarding healthcare disparities in trauma aimed at interventions to reduce disparities in patient care, ensure equitable care, and inform future approaches targeting healthcare disparities.
Breeding, Tessa; Ngatuvai, Micah; Rosander, Abigail; Maka, Piueti; Davis, Jennifer; Knowlton, Lisa M.; Hoops, Heather; and Elkbuli, Adel, "TRENDS IN DISPARITIES RESEARCH ON TRAUMA AND ACUTE CARE SURGERY OUTCOMES: A 10-YEAR SYSTEMATIC REVIEW OF ARTICLES PUBLISHED IN THE JOURNAL OF TRAUMA AND ACUTE CARE SURGERY." (2023). HPD Articles. 388.
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