Characteristics associated with undertriage of severely injured (ISS>15) children of all ages using multiple logistic regression analysis clustered on differential distance between distance from residence to primary triage hospital and distance from residence to nearest trauma center
| Characteristic | Multiple Logistic Regression Model, Outcome of Under-triage | |||
| All ages | Ages 0–13 | |||
| Odds Ratio (95% CL) | P-value | Odds Ratio (95% CL) | P-value | |
| Age, years | ||||
| 0–13 | reference | |||
| 0–364 days | NA | 0.86 (0.61–1.21) | 0.387 | |
| 1–3 | NA | 0.92 (0.62–1.37) | 0.685 | |
| 4–13 | NA | reference | ||
| 14-<18 | 2.58 (2.1–3.16) | <0.0001 | ||
| Male sex | 0.9 (0.73–1.11) | 0.324 | 0.93 (0.71–1.23) | 0.615 |
| Race/Ethnicity | ||||
| White Non-Hispanic | reference | reference | ||
| Black Non-Hispanic | 1.27 (0.87–1.84) | 0.218 | 1.1 (0.64–1.91) | 0.727 |
| Hispanic | 1.37 (1.1–1.72) | 0.006 | 1.54 (1.12–2.1) | 0.008 |
| Asian, Pacific Islander | 0.92 (0.62–1.36) | 0.671 | 0.75 (0.45–1.24) | 0.254 |
| Other or Missing | 1.02 (0.61–1.7) | 0.948 | 1.17 (0.61–2.22) | 0.643 |
| Payer | ||||
| Public | reference | reference | ||
| Private | 1.93 (1.55–2.4) | <0.0001 | 1.6 (1.17–2.2) | 0.003 |
| Private HMO* | 12.62 (8.95–17.79) | <0.0001 | 17.8 (11.1–28.7) | <0.0001 |
| Self-Insured | 2.43 (1.53–3.87) | 0.001 | 4.2 (2.1–8.42) | <0.0001 |
| PatientCounty MSA† designation | ||||
| Urban (Large central metro) | 1.31 (1.02–1.67) | 0.031 | 1.47 (1.05–2.05) | 0.026 |
| Suburban (Large fringe, Medium and Small metro) | reference | reference | ||
| Rural Micropolitan/Noncore | 0.8 (0.48–1.33) | 0.379 | 1.1 (0.48–2.53) | 0.829 |
| TraumaCenterin County of Residence | 0.94 (0.74–1.2) | 0.628 | 0.74 (0.53–1.03) | 0.077 |
| Hospital size | ||||
| <200 beds | reference | reference | ||
| 200–399 beds | 3.76 (3.01–4.69) | <0.0001 | 6.05 (4.31–8.49) | <0.0001 |
| >400 beds | 3.64 (2.6–5.11) | <0.0001 | 5.42 (3.37–8.73) | <0.0001 |
| Nonrural Hospital | 1.56 (1.08–2.27) | 0.019 | 1.01 (0.55–1.88) | 0.965 |
| Model Information | ||||
| c-statistic | 0.82 | 0.85 | ||
P values <0.05 were a priori designated as statistically significant. Model adjusted for year, body part injured, injury type and mechanism. designated as statistically significant. model adjusted for year, body part injured, injury type and mechanism.
*LEMSA: Local Emergency Medical Services Agency
†MSAMetropolitan Statistical Area