Trauma Service Utilization Increases Cost But Does Not Add Value for Minimally Injured Patients. - 2020

CONCLUSIONS: 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. Copyright (c) 2020 ISPOR-The Professional Society for Health Economics and Outcomes Research. Published by Elsevier Inc. All rights reserved. METHODS: 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. OBJECTIVE: 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. RESULTS: 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.


English

1098-3015

10.1016/j.jval.2020.02.009 [doi] S1098-3015(20)30148-0 [pii]


*Emergency Service, Hospital/ec [Economics]
*Hospital Costs/sn [Statistics & Numerical Data]
*Trauma Centers/ec [Economics]
*Wounds and Injuries/th [Therapy]
Adolescent
Adult
Aged
Aged, 80 and over
Cost-Benefit Analysis
Health Care Costs/sn [Statistics & Numerical Data]
Humans
Injury Severity Score
Length of Stay
Middle Aged
Retrospective Studies
Time Factors
Wounds and Injuries/ec [Economics]
Wounds and Injuries/pp [Physiopathology]
Young Adult


MedStar Union Memorial Hospital


Surgery


Journal Article