To corroborate anecdotal evidence with systematic evidence of a lower threshold for admission among for‐profit hospitals.
The study used Florida emergency department and hospital discharge datasets for 2012 to 2014. The treatment variable of interest was for‐profit‐designated trauma center status. The dependent variable indicated whether a patient with mild‐to‐moderate injuries was admitted after presenting as a trauma alert and then discharged to home. A separate analysis was conducted of discharges that had a 1‐day length of stay.
Generalized estimation equations with logistic distribution models were used to control for the confounding influences and developed for four groups of patients: = 1 (no probability of mortality), ≥ 0.99, ≥ 0.95, and ≥ 0.85 (zero to 15 percent probability of mortality, which includes all mild and moderate injury patients).
For the = 1 and ≥ 0.99 models, the centers' for‐profit status was the most important predictor. In the ≥ 0.95 and ≥ 0.85 models, injury type played a more important role, but for‐profit status remained important. For patients with a 1‐day stay, for‐profit status was associated with an even higher probability of hospitalization.
Considerable differences exist between for‐profit and not‐for‐profit trauma centers concerning hospitalization among the study population, which may be explained by supplier‐induced demand.
