NYMC Faculty Publications

Uninsured Status Is Associated With Worse Outcomes in a Cohort of Pediatric Patients With Traumatic Brain Injury

Author Type(s)

Faculty

DOI

10.1016/j.clineuro.2025.109024

Journal Title

Clinical Neurology and Neurosurgery

Document Type

Article

Publication Date

9-1-2025

Department

Anesthesiology

Second Department

Surgery

Third Department

Neurosurgery

Keywords

Healthcare disparities, Insurance, Pediatric, Traumatic brain injury

Disciplines

Medicine and Health Sciences

Abstract

Background: Pediatric traumatic brain injury (pTBI) is a leading cause of morbidity and mortality in children. In this study, we sought to investigate the impact of insurance status on pTBI outcomes using a single-center registry. Methods: A retrospective study was conducted of pTBI patients at a Level I Pediatric Trauma Center from January 2012 to July 2023. Patients were stratified by insurance status (private, public, uninsured) and transfer status. Results: Of 359 patients, 49 % had private insurance, 46 % public, and 5 % were uninsured. Uninsured patients had higher injury severity score (ISS), longer length of stay (LOS), and higher mortality (27.8 % vs. 2.3 % private, 0.6 % public) (p < 0.01). After adjusting for injury severity, uninsured status was a significant predictor of mortality (OR, 19.315) and prolonged LOS (OR, 5.552). Conclusions: Uninsured pTBI patients experience worse outcomes, including longer hospital stays and increased mortality. Addressing healthcare disparities through targeted interventions and policy changes is essential to improve outcomes for uninsured pTBI patients.

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