Michael Scott1, Waleed Abouelela2, David N Blitzer3, Timothy Murphy4, Gregory Peck5, Matthew Lissauer6. 1. Department of Surgery, Division of Acute Care Surgery, Rutgers-Robert Wood Johnson Medical School, New Brunswick, NJ, USA. 2. Rowan School of Osteopathic Medicine, Stratford, NJ, USA. 3. MedStar Health Baltimore, Baltimore, MD, USA. 4. Robert Wood Johnson University Hospital, Trauma Services, New Brunswick, NJ, USA. 5. Department of Surgery, Division of Acute Care Surgery, Rutgers-Robert Wood Johnson Medical School, New Brunswick, NJ, USA; Rutgers-School of Public Health, New Brunswick, NJ, USA. 6. Department of Surgery, Division of Acute Care Surgery, Rutgers-Robert Wood Johnson Medical School, New Brunswick, NJ, USA. Electronic address: ml1141@rwjms.rutgers.edu.
Abstract
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. 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. 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. 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.
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. 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. 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. 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.