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The article discusses research which assesses whether health insurance status can help predict the medical outcomes for patients with abdominal gunshot wounds who were treated at Level I trauma academic center that serves the north Louisiana, east Texas, and south Arkansas region. The U.S. Emergency Medical Treatment and Labor Act and America's National Trauma Data Bank are assessed, along with hospital length of stay and the mortality and morbidity rates for uninsured patients.

Background: While nearly 1 in 5 Americans receives health insurance coverage through Medicare, literature suggests that Medicare reimbursement is lagging behind inflation for many plastic surgery procedures., Aim: This article evaluates trends in Medicare reimbursement for gender affirmation procedures., Methods: The most common gender affirmation procedures performed at an urban academic medical center were identified in this cross-sectional study (level 4 evidence). Five nongender surgery codes were evaluated for reference. A standardized formula utilizing relative value units (RVUs) was used to calculate monetary data. Differences in reimbursement between 2014 and 2021 were calculated for each procedure., Outcome: The main outcome was inflation-adjusted difference of charges from 2014 to 2021., Results: Between 2014 and 2021, Medicare reimbursement for gender affirmation procedures had an inflation-unadjusted average change of -0.09% (vs +5.63% for the selected nongender codes) and an inflation-adjusted change of -10.03% (vs -5.54% for the selected nongender codes). Trends in reimbursement varied by category of gender-affirming procedure. The overall average compound annual growth rate had a change of -0.99% (vs -0.53% for the selected nongender codes). The average changes in work, facility, and malpractice RVUs were -1.05%, +9.52%, and -0.93%, respectively., Clinical Implications: Gender surgeons and patients should be aware that the decrease in reimbursement may affect access to gender-affirming care., Strengths and Limitations: Our study is one of the first evaluating the reimbursement rates associated with the full spectrum of gender affirmation surgery. However, our study is limited by its cross-sectional nature., Conclusions: From 2014 to 2021, Medicare reimbursement for gender affirmation procedures lagged inflation., (© The Author(s) 2023. Published by Oxford University Press on behalf of The International Society of Sexual Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Since the World Health Organization declared the coronavirus disease (COVID-19) outbreak a pandemic, significant changes have occurred in the United States as the infection spread reached and passed its exponential phase. A stringent analysis of COVID-19 epidemiologic data requires time and would generally be expected to happen with significant delay after the exponential phase of the disease is over and when the focus of the health care system is diverted away from crisis management. Although much has been said about high-risk groups and the vulnerability of the elderly and patients with underlying comorbidities, the impact of race on the susceptibility of ethnic minorities living in indigent communities has not been discussed in detail worldwide and specifically in the United States. There are currently some data on disparities between African American and Caucasian populations for COVID-19 infection and mortality. While health care authorities are reorganizing resources and infrastructure to provide care for symptomatic COVID-19 patients, they should not shy away from protecting the general public as a whole and specifically the most vulnerable members of society, such as the elderly, ethnic minorities, and people with underlying comorbidities., (©Alireza Hamidian Jahromi, Anahid Hamidianjahromi. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 12.06.2020.)