TY - JOUR
T1 - The cost of overtriage
T2 - More than one-third of low-risk injured patients were taken to major trauma centers
AU - Newgard, Craig D.
AU - Staudenmayer, Kristan
AU - Hsia, Renee Y.
AU - Mann, N. Clay
AU - Bulger, Eileen M.
AU - Holmes, James F.
AU - Fleischman, Ross
AU - Gorman, Kyle
AU - Haukoos, Jason
AU - McConnell, K. John
PY - 2013
Y1 - 2013
N2 - Regionalized trauma care has been widely implemented in the United States, with field triage by emergency medical services (EMS) playing an important role in identifying seriously injured patients for transport to major trauma centers. In this study we estimated hospitallevel differences in the adjusted cost of acute care for injured patients transported by 94 EMS agencies to 122 hospitals in 7 regions, overall and by injury severity. Among 301,214 patients, the average adjusted per episode cost of care was $5,590 higher in a level 1 trauma center than in a nontrauma hospital. We found hospital-level differences in cost among patients with minor, moderate, and serious injuries. Of the 248,342 lowrisk patients-those who did not meet field triage guidelines for transport to trauma centers-85,155 (34.3 percent) were still transported to major trauma centers, accounting for up to 40 percent of acute injury costs. Adhering to field triage guidelines that minimize the overtriage of low-risk injured patients to major trauma centers could save up to $136.7 million annually in the seven regions we studied.
AB - Regionalized trauma care has been widely implemented in the United States, with field triage by emergency medical services (EMS) playing an important role in identifying seriously injured patients for transport to major trauma centers. In this study we estimated hospitallevel differences in the adjusted cost of acute care for injured patients transported by 94 EMS agencies to 122 hospitals in 7 regions, overall and by injury severity. Among 301,214 patients, the average adjusted per episode cost of care was $5,590 higher in a level 1 trauma center than in a nontrauma hospital. We found hospital-level differences in cost among patients with minor, moderate, and serious injuries. Of the 248,342 lowrisk patients-those who did not meet field triage guidelines for transport to trauma centers-85,155 (34.3 percent) were still transported to major trauma centers, accounting for up to 40 percent of acute injury costs. Adhering to field triage guidelines that minimize the overtriage of low-risk injured patients to major trauma centers could save up to $136.7 million annually in the seven regions we studied.
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U2 - 10.1377/hlthaff.2012.1142
DO - 10.1377/hlthaff.2012.1142
M3 - Article
C2 - 24019364
AN - SCOPUS:84885336179
SN - 0278-2715
VL - 32
SP - 1591
EP - 1599
JO - Health Affairs
JF - Health Affairs
IS - 9
ER -