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

MedStar author(s):
Citation: Value in Health. 23(6):705-709, 2020 06.PMID: 32540227Institution: MedStar Union Memorial HospitalDepartment: SurgeryForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: *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 AdultYear: 2020ISSN:
  • 1098-3015
Name of journal: Value in health : the journal of the International Society for Pharmacoeconomics and Outcomes ResearchAbstract: 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.All authors: Abouelela W, Blitzer DN, Lissauer M, Murphy T, Peck G, Scott MOriginally published: Value in Health. 23(6):705-709, 2020 Jun.Fiscal year: FY2020Digital Object Identifier: Date added to catalog: 2020-08-26
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Journal Article MedStar Authors Catalog Article 32540227 Available 32540227

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.

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