Table 1.
Patient demographics and clinical characteristics stratified by discharge disposition
| Parameter | Orthopaedic trauma | Musculoskeletal infections | ||||||||
|---|---|---|---|---|---|---|---|---|---|---|
| N = 7,067,432 | Disposition | p value | AMA discharge rate per 1000 | N = 5,488,686 | Disposition | p value | AMA discharge rate per 1,000 | |||
| AMA | Formal discharge | AMA | Formal discharge | |||||||
| Weighted, number (%) | 7,067,432 (100) | 21,035 (0.30) | 7,046,397 (99.70) | – | 3.0 | 5,488,686 (100) | 116,399 (2.1) | 5,372,287 (97.9) | – | 21 |
| Age (years), mean ± SD | 68 ± 20 | 51 ± 19 | 68 ± 20 | < 0.001 | – | 56 ± 19 | 43 ± 14 | 56 ± 19 | < 0.001 | – |
| Age group (years) (%) | ||||||||||
| ≤ 44 | 16 | 39 | 16 | < 0.001 | 7.3 | 30 | 56 | 30 | < 0.001 | 40 |
| 45–64 | 20 | 36 | 20 | 5.4 | 37 | 36 | 37 | 21 | ||
| 65–74 | 14 | 10 | 14 | 2.2 | 13 | 4.5 | 13 | 7.2 | ||
| ≥ 75 | 51 | 16 | 51 | 0.91 | 20 | 3.1 | 21 | 3.2 | ||
| Sex (%) | ||||||||||
| Women | 64 | 35 | 64 | < 0.001 | 1.6 | 47 | 33 | 47 | < 0.001 | 15 |
| Men | 36 | 65 | 36 | 5.4 | 53 | 67 | 53 | 26 | ||
| Race/ethnicity (%) | ||||||||||
| White | 64 | 52 | 64 | < 0.001 | 2.4 | 58 | 53 | 58 | < 0.001 | 19 |
| Black | 5.1 | 14 | 5.0 | 8.3 | 10 | 15 | 10 | 31 | ||
| Hispanic | 5.6 | 11 | 5.6 | 6.0 | 8.6 | 13 | 8.5 | 31 | ||
| Other | 3.5 | 5.9 | 3.5 | 5.0 | 3.6 | 4.4 | 3.6 | 26 | ||
| Unknown | 22 | 17 | 22 | 2.3 | 20 | 15 | 20 | 16 | ||
| Primary health insurance (%) | ||||||||||
| Private | 22 | 20 | 22 | < 0.001 | 2.7 | 28 | 13 | 28 | < 0.001 | 10 |
| Medicare | 62 | 30 | 62 | 1.5 | 42 | 20 | 42 | 10 | ||
| Medicaid | 4.8 | 17 | 4.8 | 11 | 14 | 31 | 13 | 48 | ||
| Uninsured | 5.2 | 23 | 5.2 | 13 | 11 | 28 | 10 | 56 | ||
| Other | 5.7 | 9.2 | 5.7 | 4.8 | 5.9 | 8.1 | 5.8 | 29 | ||
| Median household income (USD) (%) | ||||||||||
| 1–38,999 | 24 | 35 | 24 | < 0.001 | 4.2 | 30 | 39 | 30 | < 0.001 | 26 |
| 39,000–47,999 | 26 | 25 | 26 | 2.8 | 26 | 25 | 26 | 20 | ||
| 48,000–62,999 | 25 | 22 | 25 | 2.5 | 23 | 21 | 23 | 18 | ||
| ≥ 63,000 | 25 | 18 | 25 | 2.1 | 21 | 15 | 21 | 15 | ||
| Number of comorbidities (%) | ||||||||||
| 0 | 23 | 43 | 23 | < 0.001 | 5.6 | 21 | 38 | 21 | < 0.001 | 38 |
| 1 | 21 | 22 | 21 | 3.3 | 20 | 25 | 20 | 26 | ||
| ≥ 2 | 56 | 34 | 57 | 1.8 | 59 | 37 | 59 | 13 | ||
| Specific conditions (%) | ||||||||||
| Alcohol abuse/dependence | 4.4 | 22 | 4.4 | < 0.001 | 15 | 3.8 | 12 | 3.7 | < 0.001 | 64 |
| Opioid abuse/dependence | 0.40 | 3.4 | 0.40 | < 0.001 | 27 | 3.3 | 21 | 2.9 | < 0.001 | 131 |
| Nonopioid drug abuse/dependence | 1.1 | 8.3 | 1.1 | < 0.001 | 22 | 3.3 | 14 | 3.0 | < 0.001 | 88 |
| Psychosis | 3.1 | 5.4 | 3.1 | < 0.001 | 5.3 | 4.6 | 9.3 | 4.5 | < 0.001 | 43 |
| AIDS/HIV | 0.10 | 0.60 | 0.10 | < 0.001 | 19 | 0.80 | 2.7 | 0.70 | < 0.001 | 76 |
| Principal admission diagnosis (%) | ||||||||||
| Fracture | ||||||||||
| Neck and trunk | 21 | 31 | 21 | < 0.001 | 4.4 | – | – | – | – | – |
| Upper extremity | 13 | 23 | 14 | 5.1 | – | – | – | – | – | |
| Lower extremity | 66 | 46 | 66 | 2.1 | – | – | – | – | – | |
| Infection | ||||||||||
| Carbuncle and furuncle | – | – | – | – | – | 0.40 | 0.30 | 0.40 | < 0.001 | 20 |
| Cellulitis and abscess | – | – | – | – | – | 89 | 92 | 89 | 22 | |
| Osteomyelitis | – | – | – | – | – | 9.3 | 7.6 | 9.4 | 17 | |
| Necrotizing fasciitis | – | – | – | – | – | 0.80 | 0.30 | 0.80 | 8.9 | |
| Infective myositis | – | – | – | – | – | 0.10 | 0.10 | 0.10 | 16 | |
| Days of care, mean ± SD | 4.8 ± 14 | 3.3 ± 7.7 | 4.8 ± 14 | < 0.001 | – | 5.3 ± 11 | 3.1 ± 4.6 | 5.3 ± 11 | < 0.001 | – |
AMA = against medical advice.