The cost of overtriage: More than one-third of low-risk injured patients were taken to major trauma centers

Craig Newgard, Kristan Staudenmayer, Renee Y. Hsia, N. Clay Mann, Eileen M. Bulger, James F. Holmes, Ross Fleischman, Kyle Gorman, Jason Haukoos, Kenneth (John) McConnell

Research output: Contribution to journalArticle

65 Citations (Scopus)

Abstract

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.

Original languageEnglish (US)
Pages (from-to)1591-1599
Number of pages9
JournalHealth Affairs
Volume32
Issue number9
DOIs
StatePublished - 2013

Fingerprint

Trauma Centers
Triage
Costs and Cost Analysis
Wounds and Injuries
Emergency Medical Services
Episode of Care
Guidelines
Patient Care

ASJC Scopus subject areas

  • Health Policy

Cite this

The cost of overtriage : More than one-third of low-risk injured patients were taken to major trauma centers. / Newgard, Craig; Staudenmayer, Kristan; Hsia, Renee Y.; Mann, N. Clay; Bulger, Eileen M.; Holmes, James F.; Fleischman, Ross; Gorman, Kyle; Haukoos, Jason; McConnell, Kenneth (John).

In: Health Affairs, Vol. 32, No. 9, 2013, p. 1591-1599.

Research output: Contribution to journalArticle

Newgard, C, Staudenmayer, K, Hsia, RY, Mann, NC, Bulger, EM, Holmes, JF, Fleischman, R, Gorman, K, Haukoos, J & McConnell, KJ 2013, 'The cost of overtriage: More than one-third of low-risk injured patients were taken to major trauma centers', Health Affairs, vol. 32, no. 9, pp. 1591-1599. https://doi.org/10.1377/hlthaff.2012.1142
Newgard, Craig ; Staudenmayer, Kristan ; Hsia, Renee Y. ; Mann, N. Clay ; Bulger, Eileen M. ; Holmes, James F. ; Fleischman, Ross ; Gorman, Kyle ; Haukoos, Jason ; McConnell, Kenneth (John). / The cost of overtriage : More than one-third of low-risk injured patients were taken to major trauma centers. In: Health Affairs. 2013 ; Vol. 32, No. 9. pp. 1591-1599.
@article{1c8055eeb03c4a36b2f3e58eae760307,
title = "The cost of overtriage: More than one-third of low-risk injured patients were taken to major trauma centers",
abstract = "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.",
author = "Craig Newgard and Kristan Staudenmayer and Hsia, {Renee Y.} and Mann, {N. Clay} and Bulger, {Eileen M.} and Holmes, {James F.} and Ross Fleischman and Kyle Gorman and Jason Haukoos and McConnell, {Kenneth (John)}",
year = "2013",
doi = "10.1377/hlthaff.2012.1142",
language = "English (US)",
volume = "32",
pages = "1591--1599",
journal = "Health Affairs",
issn = "0278-2715",
publisher = "Project Hope",
number = "9",

}

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

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, Kenneth (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.

UR - http://www.scopus.com/inward/record.url?scp=84885336179&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84885336179&partnerID=8YFLogxK

U2 - 10.1377/hlthaff.2012.1142

DO - 10.1377/hlthaff.2012.1142

M3 - Article

C2 - 24019364

AN - SCOPUS:84885336179

VL - 32

SP - 1591

EP - 1599

JO - Health Affairs

JF - Health Affairs

SN - 0278-2715

IS - 9

ER -