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Citation
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Hagan MJ, Pertsch NJ, Leary OP, Xi K, Zheng B, Camara-Quintana JQ, Niu T, Sullivan PZ, Abinader JF, Telfeian AE, Gokaslan ZL, Oyelese AA, Fridley JS. World Neurosurg. 2022; ePub(ePub): ePub. |
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Abstract
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OBJECTIVE: Socioeconomic factors are known to influence outcomes following spinal trauma, but it is unclear how these factors affect healthcare utilization in acute care settings. We aimed to elucidate if sociodemographic and psychosocial factors are associated with obtaining magnetic resonance imaging (MRI), a costly imaging modality, after cervical or thoracic spine fracture.
METHODS: Data from the 2012-2016 American College of Surgeons National Trauma Data Bank was used. We assessed the relationship between receipt of MRI and patient-level sociodemographic and psychosocial factors as well as hospital characteristics while correcting for injury-specific characteristics. Multiple logistic regression was performed to assess for associations between these variables and MRI following spine trauma.
RESULTS: 213,071 patients met inclusion criteria, of whom 13.0% had an MRI (n=27,757). After adjusting for confounders in multivariate regression, patients had increased odds of MRI if they were Hispanic (OR=1.09; p=0.001) or Black (OR=1.14; p<0.001) or were diagnosed with major psychiatric disorder (OR=1.06; p=0.009), alcohol use disorder (OR=1.05; p<0.001), or substance use disorder (OR=1.10; p<0.001). Patients with Medicare (OR=0.88; p<0.001) or Medicaid (OR=0.94; p<0.011) were less likely to have an MRI than those with private insurance, while patients treated in the Northeast (OR=1.48; p<0.001) or at for-profit hospitals (OR=1.12; p<0.001) were more likely.
CONCLUSION: After adjusting for injury severity and spinal cord injury diagnosis, psychosocial comorbidities and for-profit hospital status were associated with higher odds of MRI, while public insurance was associated with lower odds.
RESULTS highlight potential biases in the provision of MRI as a costly imaging modality.
Language: en |