Trauma Service Utilization Increases Cost But Does Not Add Value for Minimally Injured Patients

Value in Health : the Journal of the International Society for Pharmacoeconomics and Outcomes Research
Michael ScottMatthew Lissauer

Abstract

Trauma care provides value to the critically injured. Our aim was to assess whether trauma team involvement adds value to the care of minimally injured patients and to define its costs. Minimally injured patients admitted to a trauma center were propensity matched and compared by involvement versus no involvement of the trauma service (TS). Demographics, injury severity, complications, length of emergency department stay, mortality, and hospital costs and charges were studied. A total of 1253 patients were enrolled, with 308 propensity matched to the following groups: TS (n = 102) and no TS (n = 206). TS demonstrated a 30% increase in total charges and costs with no difference in complications. TS did demonstrate decreased time in the emergency department but had an increased delay to operation. Findings were similar when stratified for only lower extremity injuries. TS involvement for minimally injured patients does not increase value. Reducing TS involvement while avoiding trauma undertriage may reduce costs to the healthcare system without affecting outcomes.

References

Jan 27, 2006·The New England Journal of Medicine·Ellen J MacKenzieDaniel O Scharfstein
Nov 8, 2006·Journal of Orthopaedic Trauma·Charles A GoldfarbWilliam M Ricci
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Mar 21, 2013·The Journal of Trauma and Acute Care Surgery·Nikolay BugaevReuven Rabinovici
Nov 26, 2014·The Journal of Trauma and Acute Care Surgery·Andrew TangPeter Rhee
Sep 29, 2015·Pediatric Emergency Care·Nazreen JamalLeticia Manning Ryan

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