Trauma care costs less at hospitals with lower mortality rates
Research Activities, February 2011, No. 366
Trauma care is expensive. In the case of uninsured patients, trauma centers must absorb the costs of care. Ultimately, such costs are eventually passed along to insured patients in the form of higher insurance premiums. A new study recently found that it is less expensive to care for injured patients at trauma centers with high-quality care, that is, those with lower mortality rates than would be expected given the patient's injuries and health, than at lower-quality trauma centers.
Researchers used data from the 2006 Healthcare Cost and Utilization Project database of inpatients receiving care from non-Federal hospitals in 38 States. They examined data on patient characteristics, hospital charges, and mortality rates for 67,124 trauma patients admitted to 73 trauma centers.
Between 50 and 60 percent of the facilities were teaching hospitals, with the majority being nonprofit. The three most common reasons for trauma admission were blunt trauma, car accidents, and falls. The care of patients was less expensive at Level I and Level II trauma centers with lower mortality rates (adjusted for patient severity of illness). Low-mortality-rate hospitals had lower unadjusted costs across most injury classifications compared with average- and higher-mortality-rate hospitals. However, the difference in costs between high-mortality-rate hospitals and average-mortality-rate hospitals was not significant.
According to the researchers, hospitals considered high quality had mortality rates that were 34 percent lower than average-quality hospitals. These high-quality hospitals spent nearly 22 percent less on care. Future efforts focusing on improving the quality of care may also lower health care spending for trauma care, suggest the researchers. Their study was supported in part by the Agency for Healthcare Research and Quality (HS16737).
See "The association between cost and quality in trauma: Is greater spending associated with higher-quality care?" by Laurent G. Glance, M.D., Andrew W. Dick, Ph.D., Turner M. Osler, M.D., and others in the August 2010 Annals of Surgery 252(2), pp. 217-222.