Payer Status and Increased Distance Traveled for Fracture Care in a Rural State

Abstract

Increasing volume of orthopaedic trauma at a rural level 1 trauma center was associated with increasing travel distance for patients. Specifically, there was a dramatic increase in the volume of patients presenting for the care of simple orthopaedic injuries, these patients traveled greater distances with time and were more likely to beon Medicaid. Patients presenting with emergent injuries were also more likely to be on Medicaid. The appropriate triage of orthopaedic injuries requires a well-designed trauma system, including local on-call orthopaedists who can appropriately direct the care of patients with a variety of injuries. The effect of payer status on travel distance may be addressed through changes in reimbursement. Long-distance referral of orthopaedic trauma deserves further study as it affects patient outcomes, cost, and convenience of care.

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