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  1. Trauma care reimbursement in rural hospitals : Implications for triage and trauma system design.

    Article - En anglais

    American College of Surgeons triage guidelines recommend rapid identification and transfer of seriously injured patients to regional trauma centers, bypassing local hospitals if necessary.

    This approach raises concerns about the potential negative financial impact of implementing such triage strategies on already strained rural hospitals.

    Objective 

    The purpose of this study was to determine the association between injury severity and reimbursement for trauma care in rural hospitals.

    It was our hypothesis that the seriously injured would be high cost and relatively low reimbursement patients, and thus be a significant financial liability to the rural hospital.

    This would imply that concerns by the rural hospital about triage of such patients to trauma centers would be unfounded.

    Methods 

    Data on every injured patient seen in the emergency department during two 3-month periods were obtained from three rural hospitals in the state using the American College of Surgeons Trauma Registry data base.

    Results 

    One thousand six hundred thirty patients had complete data available for analysis.

    The analyses demonstrated that as the injury severity increased, there was an increase in hospital charges, length of stay, and risk of dying.

    In contrast, the reimbursement changed little as the charges and severity increased.

    Thus, hospital losses increased in an exponential fashion as injury severity increased above 15. (...)

    Mots-clés Pascal : Traumatisme, Grave, Système santé, Qualité, Soin, Milieu rural, Hôpital, Etats Unis, Amérique du Nord, Amérique, Coût, Homme

    Mots-clés Pascal anglais : Trauma, Severe, Health system, Quality, Care, Rural environment, Hospital, United States, North America, America, Costs, Human

    Logo du centre Notice produite par :
    Inist-CNRS - Institut de l'Information Scientifique et Technique

    Cote : 96-0384704

    Code Inist : 002B30A01B. Création : 10/04/1997.