Spending more on trauma care doesn't translate to higher survival rates: study
A large-scale review of national patient records reveals that although survival rates are the same, the cost of treating trauma patients in the western United States is 33 percent higher than the bill for treating similarly injured patients in the Northeast. Overall, treatment costs were lower in the Northeast than anywhere in the United States.
The findings by Johns Hopkins researchers, published in The Journal of Trauma and Acute Care Surgery, suggest that skyrocketing health care costs could be reined in if analysts focus on how caregivers in lower-cost regions manage their patients.
At least in the case of trauma care, spending more doesnt always mean saving more lives, says study leader Adil H. Haider, M.D., M.P.H., an associate professor of surgery at the Johns Hopkins University School of Medicine and director of Hopkins Center for Surgical Trials and Outcomes Research. If doctors in the Northeast do things more economically and with good results, why cant doctors out West do the same thing? This study provides a potential road map for cutting unnecessary costs without hurting outcomes.
But researchers say they dont know exactly why costs vary by region. Haider says that it is possible that in one part of the country, it may be customary to do an expensive type of medical test prior to treatment, while in other parts, that test may not be done.
Haider notes that health care costs account for roughly 16 percent of the Gross Domestic Product (GDP) of the United States, and trauma-related disorders rank among the five most costly conditions.
For their study, Haider and his colleagues analyed three years of data from the Healthcare Cost and Utilization Projects Nationwide Inpatient Sample (NIS), the largest all-payer inpatient database publicly available in the United States. They identified 62,678 adult patients with a primary injury in one of five domains: blunt injury to the spleen, collapsed lung and bleeding in the chest, shinbone (tibia) fracture, mild traumatic brain injury and liver injury.
After controlling for a variety of factors that could bias the results including injury severity, the presence of chronic illnesses, variations in regional prices for goods the researchers estimated that the average per-person cost in the Northeast for trauma care for all five injury types combined was $14,022. The cost was 18 percent higher in the South, 22 percent more in the Midwest and 33 percent more in the West.
Of the injury types, the most expensive was for liver injury. For liver injury, the average cost of care in the Northeast was $16,213, while the cost was 18 percent more in the South, 22 percent more in the Midwest and 35 percent more in the West.
The Northeast also had the lowest costs for each of the five types of injury, while the West had the highest, even after accounting for known differences in the widely used consumer price index.
Haider, a trauma surgeon, cautions that when looking for ways to cut costs, researchers should look closely at outcomes beyond survival alone to make sure the more expensive care isnt better in some way. For example, it may be possible, he says, that higher-cost regions have patients with less pain and fewer disabilities after recovery.
If surgeons are fixing tibia fractures in the West in a way thats more expensive but makes patients more comfortable, that would not be a trivial finding, Haider says. We really need to drill down and figure out what parts of care improve outcomes and what parts drive up costs without improving any outcomes or aspects of care important to patients.
Financial support for this work was provided by: National Institutes of Health/ NIGMS K23GM093112-01; American College of Surgeons C. James Carrico Fellowship for the study of Trauma and Critical Care and Hopkins Center for Health Disparities Solutions.
Provided by Johns Hopkins University
- Uninsured trauma patients are more likely to use the ED for follow-up care Aug 25, 2011 | not rated yet | 0
- Study: Transport of trauma patients by helicopter costly but effective Apr 17, 2012 | not rated yet | 0
- Weekend hospital stays prove more deadly than other times for older people with head trauma Aug 07, 2012 | not rated yet | 0
- High-quality care associated with lower cost in trauma Feb 21, 2011 | not rated yet | 0
- Trauma center care cost-effective Aug 17, 2010 | not rated yet | 0
- Motion perception revisited: High Phi effect challenges established motion perception assumptions Apr 23, 2013 | 3 / 5 (2) | 2
- Anything you can do I can do better: Neuromolecular foundations of the superiority illusion (Update) Apr 02, 2013 | 4.5 / 5 (11) | 5
- The visual system as economist: Neural resource allocation in visual adaptation Mar 30, 2013 | 5 / 5 (2) | 9
- Separate lives: Neuronal and organismal lifespans decoupled Mar 27, 2013 | 4.9 / 5 (8) | 0
- Sizing things up: The evolutionary neurobiology of scale invariance Feb 28, 2013 | 4.8 / 5 (10) | 14
The Durability of Bone: Long Falls
7 hours ago I am doing a paper on the physics in Valve's Portal and got interested in the "Long Fall Boots" that prevent any damage no matter how far you fall. I...
Is energy convertible to matter?
9 hours ago Can we convert energy to matter?
Rotating electron as a dipole is this right?
11 hours ago An electron as shown by the Stern Gerlach experiment behaves like a dipole (albeit only in one of two states). I have been trying to figure out how...
Dipole term in multipole expansion
15 hours ago Hi. I'm having some difficult in understanding something about the dipole term in a multipole expansion. Griffiths writes the expansion as a sum of...
Bubbles in a Pre-Boiling/Boiling pot of water
17 hours ago How is it that bubbles form on the bottom of a surface of a pot of boiling water? I think that there is probably an elementary answer to this...
Assumptions of Griffith's fracture theory
May 21, 2013 Any experts on Griffith's fracture theory? I am studying the subject and I am having hard time finding out if the theory is valid for all possible...
- More from Physics Forums - Classical Physics
More news stories
Surgeons investigated sexual function in 62 patients, 50 years and older, who had received extensive spinal–pelvic instrumentation for spinal deformity at the University of Virginia Health Center. Based on their results, ...
Surgery 17 hours ago | not rated yet | 0
Physicians at Monash University and The Alfred Hospital in Melbourne, Australia describe the logistic, medical, and societal challenges faced in treating spine trauma in morbidly obese patients. Based on a case series of ...
Surgery 18 hours ago | not rated yet | 0
Arachnoid cysts are a common type of brain lesion that is usually harmless, but with a risk of rupture or bleeding. A new study identifies risk factors for rupture or bleeding in children with "incidentally" detected arachnoid ...
Surgery 18 hours ago | not rated yet | 0
Posterior fossa subdural hematoma (PFSDH) is a serious and rare condition in newborns, generally occurring after difficult deliveries. But with appropriate treatment, there's an excellent chance of good long-term outcomes ...
Surgery May 20, 2013 | not rated yet | 0
Many women in Texas who are found to have an abnormality on routine mammogram or discover a lump in one of their breasts end up having an old-fashioned surgical biopsy to find out whether the breast abnormality is malignant. ...
Surgery May 17, 2013 | not rated yet | 0
Is it permissible to harm one to save many? Those who tend to say "yes" when faced with this classic dilemma are likely to be deficient in a specific kind of empathy, according to a report published in the scientific journal ...
48 minutes ago | not rated yet | 0 |
Phthalates: Study links chemicals widely found in plastics, processed food to elevated blood pressure in children, teens
Plastic additives known as phthalates (pronounced THAL-ates) are odorless, colorless and just about everywhere: They turn up in flooring, plastic cups, beach balls, plastic wrap, intravenous tubing and—according to the ...
1 hour ago | not rated yet | 1 |
(Medical Xpress)—Native peoples in regions where cameras are uncommon sometimes react with caution when their picture is taken. The fear that something must have been stolen from them to create the photo ...
18 hours ago | 4.2 / 5 (5) | 0 |
(Medical Xpress)—Despite spending billions of dollars on research and development, drug companies have been unable to come up with effective treatments for dementia and Alzheimer's Disease (AD). Now, A. ...
16 hours ago | 4.9 / 5 (14) | 0 |
Australian scientists have charted the path of insulin action in cells in precise detail like never before. This provides a comprehensive blueprint for understanding what goes wrong in diabetes.
18 hours ago | 4.6 / 5 (7) | 0 |
Activating an enzyme known to play a role in the anti-aging benefits of calorie restriction delays the loss of brain cells and preserves cognitive function in mice, according to a study published in the May ...
12 hours ago | 5 / 5 (4) | 0 |