Table 3.
Changes in processes of care after age 65 years, 2007-17
| Sample means* | Change at age 65 years | |||||
|---|---|---|---|---|---|---|
| Age 50-64 years (n=899 454) | Age 65-79 years (n=687 123) | Expected mean† | Adjusted discontinuity (95% CI)‡ | P value§ | ||
| Trauma bay | ||||||
| Time in emergency department (mins) | 307.31 | 313.99 | 311.82 | −4.33 (−12.79 to 4.13) | 0.33 (0.58) | |
| Transfusion volume in 4 hours (mL): | ||||||
| Blood | 4.77 | 2.90 | 4.15 | −0.40 (−1.31 to 0.50) | 0.40 (0.58) | |
| Plasma | 13.49 | 9.39 | 12.29 | 1.05 (−4.43 to 6.54) | 0.72 (0.72) | |
| Platelets | 3.54 | 2.63 | 2.99 | 0.59 (−0.93 to 2.11) | 0.46 (0.58) | |
| Immediate operative intervention | 106 764 (11.87) | 50 143 (7.30) | 9.63 | −0.27 (−0.45 to −0.10) | 0.004 (0.02) | |
| Treatment intensity in hospital¶ | ||||||
| Total procedure count | 5.75 | 5.15 | 5.47 | 0.01 (−0.07 to 0.09) | 0.79 (0.95) | |
| Procedure type: | ||||||
| Imaging | 2.29 | 2.14 | 2.18 | 0.041 (0.004 to 0.08) | 0.03 (0.16) | |
| Orthopedic | 0.81 | 0.66 | 0.77 | −0.005 (−0.025 to 0.014) | 0.60 (0.95) | |
| Routine medical care | 0.52 | 0.59 | 0.56 | 0.002 (−0.007 to 0.011) | 0.71 (0.95) | |
| Admitted to ICU | 274 459 (30.51) | 224 392 (32.66) | 31.74 | −0.05 (−0.50 to 0.41) | 0.85 (0.95) | |
| ICU length of stay (days) | 1.84 | 1.80 | 1.91 | −0.001 (−0.03 to 0.03) | 0.97 (0.97) | |
| Required ventilatory support | 113 630 (12.63) | 75 288 (10.96) | 11.74 | 0.10 (−0.12 to 0.33) | 0.40 (0.95) | |
| Time on ventilator (days) | 0.93 | 0.80 | 0.92 | −0.01 (−0.05 to 0.02) | 0.54 (0.95) | |
| Time to VTE prophylaxis (mins) | 2420.82 | 2463.49 | 2490.04 | −49.86 (−108.81 to 8.96) | 0.10 (0.34) | |
| Length of stay (days) | 6.74 | 6.38 | 6.72 | −0.33 (−0.42 to −0.24) | <0.001 (<0.001) | |
| Discharge location: | ||||||
| Home | 588 324 (65.41) | 319 080 (46.44) | 58.07 | −1.99 (−2.73 to −1.27) | <0.001 (<0.001) | |
| Nursing home** | 134 499 (14.96) | 224 061 (32.61) | 22.25 | 1.56 (0.94 to 2.16) | <0.001 (<0.001) | |
| Other inpatient†† | 55 201 (5.80) | 63 130 (9.19) | 7.74 | 0.57 (0.33 to 0.80) | <0.001 (<0.001) | |
ICU=intensive care unit; VTE=venous thromboembolism.
Values are raw counts of trauma episodes (percentages).
Predicted based on local linear association between age and each outcome. The column contains the expected value of the outcome at age 65 years in the absence of Medicare eligibility.
Estimates in percentage points, when applicable.
To control the false discovery rate of independent hypotheses within families, the Benjamini-Hochberg procedure was used to adjust P values, presented in parentheses (see supplementary eMethods).
Procedure counts rely on data from 2007 to 2016 only because the NTDB transitioned from using ICD-9 to ICD-10 (international classification of diseases, ninth and 10th revision, respectively) procedure codes in 2017.
Including skilled nursing facility.
Includes discharges or transfers to a short term general hospital for inpatient, and discharges or transfers to inpatient rehabilitation or designated unit.