TY - JOUR
T1 - Geographic Variation in Outcomes after Burn Injury
T2 - A Burn Model System National Database Study
AU - Espinoza, Leda F.
AU - Friedstat, Jonathan
AU - Faoro, Nicholas
AU - Chang, Philip H.
AU - McMullen, Kara A.
AU - Simko, Laura C.
AU - Esselman, Peter
AU - Holavanahalli, Radha
AU - Ryan, Colleen M.
AU - Schneider, Jeffrey C.
N1 - Funding Information:
Conflicts of interest and sources of funding: The authors have no conflicts of interest to disclose. The contents of this article were developed under a grant from the National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR): NIDILRR grant numbers 90DP0035 and 90DPBU0001. The NIDILRR is a center within the Administration for Community Living, Department of Health and Human Services. The contents of this article do not necessarily represent the policy of NIDILRR, Administration for Community Living, Department of Health and Human Services, and you should not assume endorsement by the federal government.
Publisher Copyright:
© Wolters Kluwer Health, Inc. All rights reserved.
PY - 2020/6/1
Y1 - 2020/6/1
N2 - Background Geography is an important yet underexplored factor that may influence the care and outcomes of burn survivors. This study aims to examine the impact of geography on physical and psychosocial function after burn injury. Methods Data from the Burn Model Systems National Database (1997-2015) were analyzed. Individuals 18 years and older who were alive at discharge were included. Physical and psychosocial functions were assessed at 6, 12, and 24 months postinjury using the following patient-reported outcome measures: Community Integration Questionnaire, Physical Composite Scale and Mental Composite Scale of the 12-Item Short Form Health Survey, Satisfaction with Appearance Scale, and Satisfaction with Life Scale. Descriptive statistics were generated for demographic and medical data, and mixed regression models were used to assess the impact of geography on long-term outcomes. Results The study included 469 burn survivors from the Centers for Medicare and Medicaid Services regions 10, 31 from region 8, 477 from region 6, 267 from region 3, and 41 from region 1. Participants differed significantly by region in terms of race/ethnicity, burn size, burn etiology, and acute care length of stay (P < 0.001). In adjusted mixed model regression analyses, scores of all 5 evaluated outcome measures were found to differ significantly by region (P < 0.05). Conclusions Several long-term physical and psychosocial outcomes of burn survivors vary significantly by region. This variation is not completely explained by differences in population characteristics. Understanding these geographical differences may improve care for burn survivors and inform future policy and resource allocation.
AB - Background Geography is an important yet underexplored factor that may influence the care and outcomes of burn survivors. This study aims to examine the impact of geography on physical and psychosocial function after burn injury. Methods Data from the Burn Model Systems National Database (1997-2015) were analyzed. Individuals 18 years and older who were alive at discharge were included. Physical and psychosocial functions were assessed at 6, 12, and 24 months postinjury using the following patient-reported outcome measures: Community Integration Questionnaire, Physical Composite Scale and Mental Composite Scale of the 12-Item Short Form Health Survey, Satisfaction with Appearance Scale, and Satisfaction with Life Scale. Descriptive statistics were generated for demographic and medical data, and mixed regression models were used to assess the impact of geography on long-term outcomes. Results The study included 469 burn survivors from the Centers for Medicare and Medicaid Services regions 10, 31 from region 8, 477 from region 6, 267 from region 3, and 41 from region 1. Participants differed significantly by region in terms of race/ethnicity, burn size, burn etiology, and acute care length of stay (P < 0.001). In adjusted mixed model regression analyses, scores of all 5 evaluated outcome measures were found to differ significantly by region (P < 0.05). Conclusions Several long-term physical and psychosocial outcomes of burn survivors vary significantly by region. This variation is not completely explained by differences in population characteristics. Understanding these geographical differences may improve care for burn survivors and inform future policy and resource allocation.
KW - burn
KW - burn injury
KW - burn outcomes
KW - geography
KW - regional differences
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U2 - 10.1097/SAP.0000000000002287
DO - 10.1097/SAP.0000000000002287
M3 - Article
C2 - 32040001
AN - SCOPUS:85085232015
SN - 0148-7043
VL - 84
SP - 644
EP - 650
JO - Annals of plastic surgery
JF - Annals of plastic surgery
IS - 6
ER -