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February 2005, Vol 95, No. 2 | American Journal of Public Health 273-278
© 2005 American Public Health Association
DOI: 10.2105/AJPH.2003.036871

RESEARCH AND PRACTICE

Injuries Among Older Americans With and Without Medicare

David E. Clark, MD, Michael A. DeLorenzo, PhD, F.L. Lucas, PhD and David E. Wennberg, MD

The authors are with the Center for Outcomes Research and Evaluation, Maine Medical Center, Portland, Me. David E. Clark is also with the Harvard Injury Control Research Center, Harvard School of Public Health, Boston, Mass.

Correspondence: Requests for reprints should be sent to David E. Clark, MD, MMC Surgical Associates, Maine Medical Center, 887 Congress St, Suite 210, Portland, ME 04102 (e-mail: clarkd{at}mmc.org).

Objectives. We evaluated the generalizability of Medicare fee-for-service data for patients hospitalized with injuries.

Methods. We used 1998–2000 Medicare hospitalization data and National Hospital Discharge Survey (NHDS) data to analyze patients aged 65 years and older with principal injury diagnoses.

Results. Demographics and injury patterns were similar in Medicare data and NHDS Medicare data. Injured patients without Medicare or health maintenance organization coverage were younger, less likely to have hip fractures, and more likely to have head or chest injuries. Mortality and discharge to long-term care were not significantly affected by insurance coverage, after we controlled for injury type and severity, age, gender, and comorbidity. Medicare patients had slightly longer hospital lengths of stay.

Conclusions. Hospital outcomes are generally similar among older patients with a given anatomic injury, regardless of insurance coverage.




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