Impact of Level III verification on trauma admissions and transfer : Comparisons of two rural hospitals. Commentary.
Annual Meeting of the American Association for the Surgery of Trauma. Houston, Texas (USA), 1996/09/19.
To study the impact of Level III verification and other changes in rural hospitals on trauma delivery and to examine factors affecting transfer to a Level I trauma center.
Two rural Kentucky hospitals and a Level I trauma center.
Method of Review
Concurrent review of all trauma patients in 1988 and re-review of the same parameters in 1995.
In 1988, both hospitals had similar management practices in trauma care.
A significant number of patients were transferred for (a) patient choice, (b) serious and/or multiple trauma, (c) specialty care in non-life threatening situations, and (d) to exclude a potentially serious problem seen on radiologic evaluation (usually questionable cervical spine or widened mediastinum).
Both hospitals had major changes in trauma delivery.
One hospital received Level III verification, and the other had changes that lessened the general surgeon's involvement with initial evaluation and treatment.
A re-review in 1995 disclosed major changes at both institutions.
Transfers to exclude radiologic abnormalities had virtually disappeared.
The Level III status had increased the surgical involvement in that hospital ; there was actually an increase in patients transferred to the Level I hospital and an increase in patient acuity.
More operations were performed locally, and the care was more efficiently delivered. (...)
Mots-clés Pascal : Service hospitalier, Traumatologie, Milieu rural, Etude comparative, Hôpital, Hospitalisation, Transfert, Homme
Mots-clés Pascal anglais : Hospital ward, Traumatology, Rural environment, Comparative study, Hospital, Hospitalization, Transfer, Human
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 97-0251604
Code Inist : 002B30A04D. Création : 11/06/1997.