@article{TEXTUAL,
      recid = {5616},
      author = {Nguyen, Jessy K. and Sanghavi, Prachi},
      title = {Comparison of survival outcomes among older adults with  major trauma after trauma center versus non-trauma center  care in the United States},
      journal = {Health Services Research },
      address = {2023-02-24},
      number = {TEXTUAL},
      abstract = {&lt;p&gt;Objective: To compare level 1 and 2 trauma centers with  similarly sized non-trauma centers on survival after major  trauma among older adults.&lt;/p&gt; &lt;p&gt;Data sources and study  setting: We used claims of 100% of 2012-2017 Medicare  fee-for-service beneficiaries who received hospital care  after major trauma.&lt;/p&gt; &lt;p&gt;Study design: Survival  differences were estimated after applying  propensity-score-based overlap weights. Subgroup analyses  were performed for ambulance-transported patients and by  external cause. We assessed the roles of prehospital care,  hospital quality, and volume.&lt;/p&gt; &lt;p&gt;Data collection: Data  were obtained from the Centers for Medicare and Medicaid  Services.&lt;/p&gt; &lt;p&gt;Principal findings: Thirty-day mortality  was higher overall at level 1 versus non-trauma centers by  2.2 (95% confidence interval [CI]: 1.8, 2.6) percentage  points (pp). Thirty-day mortality was higher at level 1  versus non-trauma centers by 2.3 (95% CI: 1.9, 2.8) pp for  falls and 2.3 (95% CI: 0.2, 4.4) pp for motor vehicle  crashes. Differences persisted at 1 year. Level 1 and 2  trauma centers had similar outcomes. Hospital quality and  volume did not explain these differences. In the  ambulance-transported subgroup, after adjusting for  prehospital variables, no statistically significant  differences remained.&lt;/p&gt; &lt;p&gt;Conclusions: Trauma centers  may not provide longer survival than similarly sized  non-trauma hospitals for severely injured older  adults.&lt;/p&gt;},
      url = {http://knowledge.uchicago.edu/record/5616},
}