BACKGROUND: The 4.8 million Medicare enrollees aged 18-64 are permanently and totally disabled Social Security Disability Insurance (SSDI) beneficiaries or suffer from end-stage renal disease. Such catastrophic medical conditions as spinal cord injury and AIDS are known to raise risk of suicide death. The severely disabled also often depend on caregivers (a situation open to frustration and abuse) and may be at risk of becoming homeless. Although we hypothesize this group has an elevated injury risk, data to verify that hypothesis has not been accessible. METHODS: We cleaned and pooled 1997 hospital discharge data from 19 states that mandate external cause coding or voluntarily cause-code most discharges. These states house 50% of the US population. Denominator data to evaluate injury rates came from the Health Care Financing Administration for Medicare enrollees and from the Census Bureau for other people. RESULTS: The data include 497,031 injury discharges of people aged 19-64, including 39,596 discharges of Medicare enrollees. Medicare enrollees are 3% of people aged 19-64 but 8% of hospitalized injury patients. Their hospital-admitted crude relative injury risks, expressed as multiples of the risk of other US residents of comparable age, are 2.64 for unintentional injury, 4.40 for suicide, 1.56 for assault, and 4.60 for injuries of undetermined intent. The elevated risks decline with age; age-adjusted relative risks are higher. Relative risks are higher for female than male enrollees. CONCLUSIONS: Medicare SSDI beneficiaries are at severe risk of injury. Physicians and public health professional need to target preventive efforts on this group.
Learning Objectives: At the conclusion of the session, the participants will be able to: Describe the level of injury risk of the Medicare non-elderly Understand that this is a large population Recognize the need for injury prevention targeting this population
Keywords: Injury Risk, Disability
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: none
Disclosure not received
Relationship: Not Received.