The association between cost and quality in trauma: is greater spending associated with higher-quality care?

Annals of Surgery
Laurent G GlanceDana B Mukamel

Abstract

To examine the association between trauma center quality and costs. Current efforts to reduce health care costs and improve health care quality require a better understanding of the relationship between cost and quality. Using data from the Healthcare Cost and Utilization Projects Nationwide Inpatient Sample, we performed a retrospective observational study of 67,124 trauma patients admitted to 73 trauma centers. Generalized linear models were used to explore the association between hospital cost and in-hospital mortality, controlling for hospital and patient factors as follows: injury diagnoses, age, gender, mechanism of injury, comorbidities, teaching status, hospital ownership, geographic region, and hospital wages. Patients treated in hospitals with low risk-adjusted mortality rates had significantly lower costs than those treated in average-quality hospitals. The relative cost of patients treated in high-quality hospitals was 0.78 (95% confidence interval: 0.64, 0.95) compared with average-quality hospitals. The cost of treating patients in average- and high-mortality trauma centers was similar. In this study based on the Healthcare Cost and Utilization Project Nationwide Inpatient Sample, the care of injured patients is l...Continue Reading

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Citations

Oct 19, 2011·Archives of Surgery·Laurent G GlanceDana B Mukamel
Aug 11, 2012·BMC Health Services Research·Laurent G GlancePatricia W Stone
Sep 1, 2017·The International Journal of Health Planning and Management·Yadava B Jeve
Apr 16, 2020·Applied Health Economics and Health Policy·Sara JamalabadiJonas Schreyögg
Jul 22, 2010·Annals of Surgery·Robert Lawrence Reed
Jul 20, 2020·International Journal of Clinical Practice·Marie-Pier PattonJulien Clément
Apr 13, 2021·Value in Health : the Journal of the International Society for Pharmacoeconomics and Outcomes Research·Teegwendé V PorgoAlexis F Turgeon

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