{"id":"https://openalex.org/W4409430711","doi":"https://doi.org/10.37765/ajmc.2025.89688","title":"Insurance Payer Is Associated With Length of Stay After Traumatic Brain Injury","display_name":"Insurance Payer Is Associated With Length of Stay After Traumatic Brain Injury","publication_year":2025,"publication_date":"2025-02-21","ids":{"openalex":"https://openalex.org/W4409430711","doi":"https://doi.org/10.37765/ajmc.2025.89688","pmid":"https://pubmed.ncbi.nlm.nih.gov/40227397"},"language":"en","primary_location":{"id":"doi:10.37765/ajmc.2025.89688","doi":"https://doi.org/10.37765/ajmc.2025.89688","is_oa":false,"landing_page_url":"https://doi.org/10.37765/ajmc.2025.89688","pdf_url":null,"source":{"id":"https://openalex.org/S57989705","display_name":"The American Journal of Managed Care","issn_l":"1088-0224","issn":["1088-0224","1936-2692"],"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["cwts-core","doyens","jufo-1","medline","norway-1"],"host_organization":"https://openalex.org/P4322697529","host_organization_name":"Managed Care and Healthcare Communications","host_organization_lineage":["https://openalex.org/P4322697529"],"host_organization_lineage_names":["Managed Care and Healthcare Communications"],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"The American Journal of Managed Care","raw_type":"journal-article"},"volume":null,"type":"article","indexed_in":["crossref","pubmed"],"open_access":{"is_oa":true,"oa_status":"green","oa_url":"https://escholarship.org/uc/item/1jq0h6kg","any_repository_has_fulltext":true},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5084063845","display_name":"John K. Yue","orcid":"https://orcid.org/0000-0001-9694-7722","observed_orcids":["https://orcid.org/0000-0001-9694-7722"]},"institutions":[{"id":"https://openalex.org/I180670191","display_name":"University of California, San Francisco","ror":"https://ror.org/043mz5j54","country_code":"US","type":"education","lineage":["https://openalex.org/I180670191"]}],"countries":["US"],"is_corresponding":true,"raw_author_name":"Yue,John;Krishnan,Nishanth;Toretsky,Christopher;Hsia,Renee;Manley,Geoffrey;Boscardin,W.;Makam,Anil;DiGiorgio,Anthony;","raw_affiliation_strings":["Department of Neurological Surgery, University of California, San Francisco, 505 Parnassus Ave, M773, San Francisco, CA 94143. Email: john.yue@ucsf.edu"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Neurological Surgery, University of California, San Francisco, 505 Parnassus Ave, M773, San Francisco, CA 94143. Email: john.yue@ucsf.edu","institution_ids":["https://openalex.org/I180670191"]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":1,"corresponding_author_ids":["https://openalex.org/A5084063845"],"corresponding_institution_ids":["https://openalex.org/I180670191"],"apc_list":null,"apc_paid":null,"fwci":1.2459,"has_fulltext":false,"cited_by_count":2,"citation_normalized_percentile":{"value":0.78131169,"is_in_top_1_percent":false,"is_in_top_10_percent":false},"cited_by_percentile_year":{"min":96,"max":97},"biblio":{"volume":"31","issue":"4","first_page":"173","last_page":"181"},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T10416","display_name":"Traumatic Brain Injury Research","score":0.5576000213623047,"subfield":{"id":"https://openalex.org/subfields/2713","display_name":"Epidemiology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T10416","display_name":"Traumatic Brain Injury Research","score":0.5576000213623047,"subfield":{"id":"https://openalex.org/subfields/2713","display_name":"Epidemiology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T11467","display_name":"Trauma and Emergency Care Studies","score":0.22840000689029694,"subfield":{"id":"https://openalex.org/subfields/2711","display_name":"Emergency Medicine"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T10706","display_name":"Traumatic Brain Injury and Neurovascular Disturbances","score":0.14869999885559082,"subfield":{"id":"https://openalex.org/subfields/2728","display_name":"Neurology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/traumatic-brain-injury","display_name":"traumatic brain injury","score":1.0},{"id":"https://openalex.org/keywords/length-of-hospital-stay","display_name":"length of hospital stay","score":0.7429999709129333},{"id":"https://openalex.org/keywords/medicaid","display_name":"Medicaid","score":0.8579999804496765},{"id":"https://openalex.org/keywords/managed-care-organizations","display_name":"managed care organizations","score":0.9700000286102295},{"id":"https://openalex.org/keywords/fee-for-service","display_name":"fee-for-service","score":0.9490000009536743},{"id":"https://openalex.org/keywords/types-of-insurance","display_name":"insurance type","score":0.703000009059906},{"id":"https://openalex.org/keywords/post-acute-care","display_name":"post-acute care","score":0.7699999809265137},{"id":"https://openalex.org/keywords/hospital-discharge","display_name":"hospital discharge","score":0.6349999904632568},{"id":"https://openalex.org/keywords/severe-traumatic-brain-injury","display_name":"severe traumatic brain injury","score":0.8740000128746033},{"id":"https://openalex.org/keywords/competing-risks","display_name":"competing risks","score":0.4309999942779541},{"id":"https://openalex.org/keywords/california","display_name":"California","score":0.42500001192092896}],"concepts":[{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.9399235248565674},{"id":"https://openalex.org/C2781017439","wikidata":"https://www.wikidata.org/wiki/Q1995526","display_name":"Traumatic brain injury","level":2,"score":0.6690635681152344},{"id":"https://openalex.org/C2780265253","wikidata":"https://www.wikidata.org/wiki/Q1416012","display_name":"Managed care","level":3,"score":0.41905349493026733},{"id":"https://openalex.org/C177713679","wikidata":"https://www.wikidata.org/wiki/Q679690","display_name":"Intensive care medicine","level":1,"score":0.3706297278404236},{"id":"https://openalex.org/C194828623","wikidata":"https://www.wikidata.org/wiki/Q2861470","display_name":"Emergency medicine","level":1,"score":0.36386409401893616},{"id":"https://openalex.org/C545542383","wikidata":"https://www.wikidata.org/wiki/Q2751242","display_name":"Medical emergency","level":1,"score":0.3357086777687073},{"id":"https://openalex.org/C118552586","wikidata":"https://www.wikidata.org/wiki/Q7867","display_name":"Psychiatry","level":1,"score":0.3340255320072174},{"id":"https://openalex.org/C160735492","wikidata":"https://www.wikidata.org/wiki/Q31207","display_name":"Health care","level":2,"score":0.24395188689231873},{"id":"https://openalex.org/C162324750","wikidata":"https://www.wikidata.org/wiki/Q8134","display_name":"Economics","level":0,"score":0.0},{"id":"https://openalex.org/C50522688","wikidata":"https://www.wikidata.org/wiki/Q189833","display_name":"Economic growth","level":1,"score":0.0}],"mesh":[{"descriptor_ui":"D000070642","descriptor_name":"Brain Injuries, Traumatic","qualifier_ui":"Q000191","qualifier_name":"economics","is_major_topic":true},{"descriptor_ui":"D000070642","descriptor_name":"Brain Injuries, Traumatic","qualifier_ui":"Q000191","qualifier_name":"economics","is_major_topic":true},{"descriptor_ui":"D000070642","descriptor_name":"Brain Injuries, Traumatic","qualifier_ui":"Q000534","qualifier_name":"rehabilitation","is_major_topic":true},{"descriptor_ui":"D000070642","descriptor_name":"Brain Injuries, Traumatic","qualifier_ui":"Q000534","qualifier_name":"rehabilitation","is_major_topic":true},{"descriptor_ui":"D000070642","descriptor_name":"Brain Injuries, Traumatic","qualifier_ui":"Q000628","qualifier_name":"therapy","is_major_topic":true},{"descriptor_ui":"D000070642","descriptor_name":"Brain Injuries, Traumatic","qualifier_ui":"Q000628","qualifier_name":"therapy","is_major_topic":true},{"descriptor_ui":"D000328","descriptor_name":"Adult","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D000328","descriptor_name":"Adult","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D000368","descriptor_name":"Aged","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D000368","descriptor_name":"Aged","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D002140","descriptor_name":"California","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D002140","descriptor_name":"California","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D005260","descriptor_name":"Female","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D005260","descriptor_name":"Female","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D006801","descriptor_name":"Humans","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D006801","descriptor_name":"Humans","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D007902","descriptor_name":"Length of Stay","qualifier_ui":"Q000706","qualifier_name":"statistics & numerical data","is_major_topic":true},{"descriptor_ui":"D007902","descriptor_name":"Length of Stay","qualifier_ui":"Q000706","qualifier_name":"statistics & numerical data","is_major_topic":true},{"descriptor_ui":"D008297","descriptor_name":"Male","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D008297","descriptor_name":"Male","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D008329","descriptor_name":"Managed Care Programs","qualifier_ui":"Q000706","qualifier_name":"statistics & numerical data","is_major_topic":false},{"descriptor_ui":"D008329","descriptor_name":"Managed Care Programs","qualifier_ui":"Q000706","qualifier_name":"statistics & numerical data","is_major_topic":false},{"descriptor_ui":"D008484","descriptor_name":"Medicaid","qualifier_ui":"Q000706","qualifier_name":"statistics & numerical data","is_major_topic":true},{"descriptor_ui":"D008484","descriptor_name":"Medicaid","qualifier_ui":"Q000706","qualifier_name":"statistics & numerical data","is_major_topic":true},{"descriptor_ui":"D008875","descriptor_name":"Middle Aged","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D008875","descriptor_name":"Middle Aged","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D014481","descriptor_name":"United States","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D014481","descriptor_name":"United States","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D018588","descriptor_name":"Fee-for-Service Plans","qualifier_ui":"Q000706","qualifier_name":"statistics & numerical data","is_major_topic":false},{"descriptor_ui":"D018588","descriptor_name":"Fee-for-Service Plans","qualifier_ui":"Q000706","qualifier_name":"statistics & numerical data","is_major_topic":false},{"descriptor_ui":"D019458","descriptor_name":"Insurance Coverage","qualifier_ui":"Q000706","qualifier_name":"statistics & numerical data","is_major_topic":true},{"descriptor_ui":"D019458","descriptor_name":"Insurance Coverage","qualifier_ui":"Q000706","qualifier_name":"statistics & numerical data","is_major_topic":true},{"descriptor_ui":"D019467","descriptor_name":"Subacute Care","qualifier_ui":"Q000706","qualifier_name":"statistics & numerical data","is_major_topic":false},{"descriptor_ui":"D019467","descriptor_name":"Subacute Care","qualifier_ui":"Q000706","qualifier_name":"statistics & numerical data","is_major_topic":false}],"locations_count":3,"locations":[{"id":"doi:10.37765/ajmc.2025.89688","doi":"https://doi.org/10.37765/ajmc.2025.89688","is_oa":false,"landing_page_url":"https://doi.org/10.37765/ajmc.2025.89688","pdf_url":null,"source":{"id":"https://openalex.org/S57989705","display_name":"The American Journal of Managed Care","issn_l":"1088-0224","issn":["1088-0224","1936-2692"],"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["cwts-core","doyens","jufo-1","medline","norway-1"],"host_organization":"https://openalex.org/P4322697529","host_organization_name":"Managed Care and Healthcare Communications","host_organization_lineage":["https://openalex.org/P4322697529"],"host_organization_lineage_names":["Managed Care and Healthcare Communications"],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"The American Journal of Managed Care","raw_type":"journal-article"},{"id":"pmid:40227397","doi":null,"is_oa":false,"landing_page_url":"https://pubmed.ncbi.nlm.nih.gov/40227397","pdf_url":null,"source":{"id":"https://openalex.org/S4306525036","display_name":"PubMed","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"The American journal of managed care","raw_type":"Journal Article"},{"id":"pmh:oai:escholarship.org:ark:/13030/qt1jq0h6kg","doi":null,"is_oa":true,"landing_page_url":"https://escholarship.org/uc/item/1jq0h6kg","pdf_url":null,"source":{"id":"https://openalex.org/S4306400115","display_name":"eScholarship (California Digital Library)","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I2801248553","host_organization_name":"California Digital Library","host_organization_lineage":["https://openalex.org/I2801248553"],"host_organization_lineage_names":[],"type":"repository"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"submittedVersion","is_accepted":false,"is_published":false,"raw_source_name":"The American Journal of Managed Care, vol 31, iss 4","raw_type":"article"}],"best_oa_location":{"id":"pmh:oai:escholarship.org:ark:/13030/qt1jq0h6kg","doi":null,"is_oa":true,"landing_page_url":"https://escholarship.org/uc/item/1jq0h6kg","pdf_url":null,"source":{"id":"https://openalex.org/S4306400115","display_name":"eScholarship (California Digital Library)","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I2801248553","host_organization_name":"California Digital Library","host_organization_lineage":["https://openalex.org/I2801248553"],"host_organization_lineage_names":[],"type":"repository"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"submittedVersion","is_accepted":false,"is_published":false,"raw_source_name":"The American Journal of Managed Care, vol 31, iss 4","raw_type":"article"},"sustainable_development_goals":[{"score":0.9907000064849854,"display_name":"Good health and well-being","id":"https://metadata.un.org/sdg/3"}],"sustainable_development_goals_aurora":[{"score":0.47999998927116394,"display_name":"Decent work and economic growth","id":"https://metadata.un.org/sdg/8"}],"study_designs":[{"display_name":"Observational Study","id":"https://openalex.org/study-designs/observational-study"}],"awards":[],"funders":[],"has_content":{"pdf":false,"grobid_xml":false},"content_urls":null,"referenced_works_count":0,"referenced_works":[],"related_works":["https://openalex.org/W2106050080","https://openalex.org/W2326314491","https://openalex.org/W2007907621","https://openalex.org/W1993239342","https://openalex.org/W4246727323","https://openalex.org/W631483513","https://openalex.org/W3206692032","https://openalex.org/W2094583993","https://openalex.org/W2109656835","https://openalex.org/W2085897904"],"abstract_inverted_index":{"OBJECTIVES:":[0],"Timely":[1],"provision":[2],"of":[3,24,28,119,135,153,187,190,200],"postacute":[4],"care":[5,52],"(PAC)":[6],"rehabilitation":[7],"is":[8,21,45,270],"critical":[9],"for":[10,35,67,101,146],"achieving":[11],"functional":[12],"recovery":[13],"after":[14,31],"traumatic":[15],"brain":[16],"injury":[17],"(TBI).":[18],"Medicaid":[19,40,216,268,282],"coverage":[20,48],"a":[22,33,50,191],"predictor":[23],"prolonged":[25],"hospital":[26],"length":[27],"stay":[29],"(LOS)":[30],"TBI,":[32,43],"proxy":[34],"decreased":[36,285],"PAC":[37,286],"access.":[38,287],"Among":[39],"patients":[41,68,112,147,202,277],"with":[42,69,113,148,220,224,239,244,272,278,281],"it":[44],"unknown":[46],"whether":[47],"under":[49],"managed":[51],"organization":[53],"(MCO)":[54],"or":[55,123,167,178,181],"fee-for-service":[56],"(FFS)":[57],"model":[58],"predicts":[59],"differences":[60],"in":[61,111,247,257,275],"LOS.":[62],"STUDY":[63],"DESIGN:":[64],"Discharge":[65,142],"data":[66],"TBI":[70,115,149,260,279],"from":[71],"318":[72],"California":[73,133],"hospitals":[74],"between":[75,95],"2017":[76],"and":[77,98,104,139,194,256],"2019":[78],"were":[79,129,162,203,218],"obtained.":[80],"We":[81],"used":[82],"multivariable":[83],"regression":[84],"models,":[85],"treating":[86],"mortality/hospice":[87],"disposition":[88],"as":[89],"competing":[90],"risks,":[91],"to":[92],"evaluate":[93],"associations":[94],"insurance":[96,176],"type":[97],"LOS,":[99],"adjusting":[100],"sociodemographic":[102],"factors":[103],"illness":[105],"severity.":[106],"Sensitivity":[107],"analysis":[108],"was":[109,144,242],"conducted":[110],"severe":[114,259],"identified":[116],"by":[117],"receipt":[118],"intracranial":[120],"pressure":[121],"monitoring":[122],"trauma":[124],"craniotomy/craniectomy.":[125],"Adjusted":[126],"HRs":[127],"(aHRs)":[128],"reported.":[130],"METHODS:":[131],"The":[132],"Department":[134],"Health":[136],"Care":[137],"Access":[138],"Information":[140],"Patient":[141],"Dataset":[143],"queried":[145],"using":[150],"International":[151],"Classification":[152],"Diseases,":[154],"Tenth":[155],"Revision,":[156],"Clinical":[157],"Modification":[158],"codes.":[159],"Exclusion":[160],"criteria":[161],"younger":[163],"than":[164,169,174],"18":[165],"years":[166],"older":[168],"65":[170],"years,":[171],"payer":[172],"other":[173],"private":[175],"(PI)":[177],"Medicaid,":[179],"death":[180],"hospice":[182],"discharge":[183],"within":[184],"5":[185],"days":[186],"hospitalization,":[188],"presence":[189],"do-not-resuscitate":[192],"order,":[193],"nonemergency":[195],"admission.":[196],"RESULTS:":[197],"A":[198],"total":[199],"39,834":[201],"analyzed":[204],"(FFS,":[205],"24.2%;":[206],"MCO,":[207],"33.2%;":[208],"PI,":[209],"42.6%).":[210],"Competing":[211],"risk":[212],"regressions":[213],"showed":[214],"that":[215],"models":[217],"associated":[219,243,271],"longer":[221,245],"LOS":[222,246,274],"compared":[223,280],"PI":[225],"(FFS:":[226],"aHR,":[227,233],"0.80;":[228],"95%":[229,235,253,264],"CI,":[230,236,254,265],"0.80-0.83;":[231],"MCO:":[232],"0.92;":[234],"0.87-0.96).":[237],"Compared":[238],"MCOs,":[240,283],"FFS":[241,269],"the":[248,258],"overall":[249],"cohort":[250],"(aHR,":[251,262],"0.88;":[252],"0.85-0.91)":[255],"subgroup":[261],"0.90;":[263],"0.82-0.99).":[266],"CONCLUSIONS:":[267],"increased":[273],"hospitalized":[276],"suggesting":[284]},"counts_by_year":[{"year":2026,"cited_by_count":2}],"updated_date":"2026-09-26T08:19:03.415552","created_date":"2025-10-10T00:00:00"}
