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August 15, 2012

Costs vary greatly in trauma care, but patient outcomes do not

Daily Briefing

Spending more on trauma care per patient does not mean better outcomes, according to a study in the Journal of Trauma and Acute Care Surgery that examined trauma care costs across the nation.

The Johns Hopkins University School of Medicine study found that although trauma care spending can vary as much as 37% between western and northeastern states, there is no significant difference in overall trauma-related mortality rates from region to region.

Researchers surveyed three years of administrative data on more than 62,000 trauma care patients across the country and compared prices on five typical conditions: liver injury, tibia fracture, blunt splentic injury, pneumothorax/hemothorax, and moderate traumatic brain injury.

The researchers uncovered higher costs in the west; the average per patient cost for trauma care was $18,929 in the West versus $14,022 in the Northeast.

Additional spending did not always mean saving more lives, according to lead author Adil Haider. "If doctors in the Northeast do things more economically and with good results, why can't doctors out West do the same thing?"

Haider did concede that additional comparative-effectiveness research into trauma care could reveal whether higher spending is linked to other areas like patient satisfaction, even if the mortality rates remain the same.

"If surgeons are fixing tibia fractures in the West in a way that's more expensive but makes patients more comfortable, that would not be a trivial finding," Haider says.

Although trauma is the top cause of death for younger people, it remains one of the least-funded research specialties, according to Haider (Haider et al., Journal of Trauma and Acute Care Surgery, 8/9 [subscription required]; Smith, MedPage Today, 8/9; McKinney, Modern Healthcare, 8/11 [subscription required]).

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