The provision of optimal burn care is a resource-intensive endeavor. The American Burn Association has developed criteria to help guide the decision to refer a patient to a burn center for definitive injury care. The purpose of this study was to compare the patient and injury characteristics of patients admitted to the single verified burn center in Washington State with those treated at other facilities in the state. We performed a retrospective review of all patients admitted to a hospital with a burn injury in Washington State from 1987 to 2005 using the state's discharge database (Comprehensive Hospital Abstract Reporting System). Patient and injury factors of patients admitted to the state's single verified burn center or at other hospitals were compared. Multivariate poisson regression was used to calculate the relative risk of injury and patient factors that were significantly associated with admission to the verified burn center. From 1987 to 2005, a total of 16,531 patients were admitted to a Washington State hospital after burn injury. Of these patients, 8624 (52.2%) were treated definitively at the University of Washington Burn Center. Patients treated at this verified center had larger overall burn size (7.4% vs 4.5% TBSA, P < .001), higher percent full-thickness burn (4.3% vs 1.2%, P < .001), and higher rates of inhalation injury (2.3% vs 1.5%, P = .005). Uninsured status (relative risk = 1.46, 95% confidence interval = 1.4-1.5) was also significantly associated with treatment at the verified burn center. Injury severity and payer status were both found to be independent predictors of treatment at the single verified burn center in Washington.The provision of optimal burn care is a resource-intensive endeavor, requiring specialized staff, equipment, and other resources. Burn centers were developed to provide facilities with the available resources and expertise needed to achieve optimal outcomes following burn injury. 1 Accordingly, the American Burn Association (ABA) has developed criteria to help guide the decision to refer a patient to a burn center for definitive injury care. The University of Washington Burn Center is the single verified burn center for Washington State and provides burn care for the states of Alaska, Montana, and Idaho. 4 Nearly half of the patients admitted to the UW Burn Center are transferred following initial evaluation at another facility. 5,6 The number and injury characteristics of those patients with burn injuries treated definitively at other facilities (ie, not transferred to the burn center) are unknown. The purpose of this study was to review the location of definitive care for patients treated for burn injury in Washington State during a 19-year period and to examine the factors associated with treatment at the verified burn center using the state's discharge database. We hypothesized that injury severity and payer status would both be significant predictors of treatment location.
METHODS
Study OverviewThis is a retrospective cohort study of patients who w...