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Characteristics and Outcomes of Trauma in Patients with Developmental Disabilities in Massachusetts 2008-2011
Limited systematically collected data is available on trauma and associated outcomes among persons with developmental disabilities (DD), who are more vulnerable to injury and can present a unique set of challenges when receiving post-injury care.
METHODS
Utilizing an ICD-9-CM-based definition of DD, we identified patients with DD and examined their characteristics and outcomes of trauma in the statewide Massachusetts State Trauma Registry (2008-2011). Prevalence rates of DD and DD subtypes were analyzed overall and by race, sex, age group, hospital type and geographic region. Select patient and injury characteristics were summarized and compared by DD status.
RESULTS
Of the 140,751 trauma patients in the registry, 973 (0.65%) had a diagnostic code for DD. DD prevalence was the highest among patients ages 45-65 years (1.33%), males (0.76% vs. 0.62%), and non-Hispanic whites (0.87%). Non-designated trauma centers treated a higher proportion of DD patients (0.91% vs. 0.55-0.64%; p<0.01). DD patients were younger (48.9 vs. 54.9y; p<0.001). Although there was no difference in injury severity and death rate by DD status, DD patients stayed in hospital 1.3 days longer (p<0.001), and were more likely to be discharged to rehabilitation and long term care facilities, less likely to home and acute care settings.
CONCLUSIONS
Utilizing an ICD-9-CM based indicator as a proxy identifier for DD, analyses of a statewide trauma registry suggest select similarities and disparities in trauma characteristics and outcomes between patients with and without DD. These data are useful for injury prevention planning and resource allocation.
Learning Areas:
EpidemiologyPublic health or related research
Learning Objectives:
Assess the prevalence of developmental disabilities among trauma patients;
Evaluate disparities in trauma care and outcomes in patients with developmental disabilities compared to those without;
Discuss the utility of statewide trauma registry data to inform injury prevention policies, programming and efforts to reduce disability-related health disparities
Keyword(s): Disabilities, Health Disparities/Inequities
Qualified on the content I am responsible for because: I have been principle investigator or co-investigator of multiple NIH or CDC funded research projects on chronic disease and injury prevention, health disparities. I am Associate Professor at the University of Massachusetts Medical School. The results in this abstract is from my ongoing NIH funded project.
Any relevant financial relationships? No
I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.