An Analysis of the Critical Problem of Trauma Center Reimbursement

Eastman, A. Brent; Rice, Christie; Bishop, Gregory S.; Richardson, J. David

doi:10.1097/00005373-199107000-00007

The Journal of Trauma: Injury, Infection, and Critical Care

1991

DOI: 10.1097/00005373-199107000-00007

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An Analysis of the Critical Problem of Trauma Center Reimbursement

A. Brent Eastman

Christie Rice

Gregory S. Bishop³

et al.

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1992

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Cited by 51 publications

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“…Recovery from accidents (Rutledge, et al, 1996), cardiac events (Wynn, 1991) and other illnesses have all been found to include a time frame within which some impacts are preventable and reversible. The chances of survival after a traumatic event improve if the victim has immediate access to appropriate diagnosis and treatment (Eastman, et al, 1991). eas often experience delays in treatment due, first, to lack of capacity in rural areas to deal with serious trauma and, second, to the distance to an urban center with sufficient capacity to deal with the situation.…”

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confidence: 99%

Using Telemedicine to Avoid Transfer of Rural Emergency Department Patients

Hicks¹,

Boles²,

Hudson³

et al. 2001

The Journal of Rural Health

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Access to emergency treatment in rural areas can often mean the difference between life and death. Telemedicine technologies have the potential of providing earlier diagnosis and intervention, of saving lives and of avoiding unnecessary transfers from rural hospital emergency departments to urban hospitals. This study examined the hypothetical impact of telemedicine services on patients served by the emergency departments of two rural Missouri hospitals and the potential financial impact on the affected hospitals. Of the 246 patients transferred to the hub hospital from the two facilities during 1996, 161 medical records (65.4 percent) were analyzed. Using a conservative approach, only 12 of these cases were identified as potentially avoidable transfers with the use of telemedicine. Of these 12, 5 were admitted to the hub hospital after transfer. In addition to this conservative estimate of avoidable transfers based on current availability of resources in the rural hospitals, two more aggressive scenarios were developed, based on an assumption of increased service availability in the rural hospitals. Economic multipliers were used to estimate the financial impacts on communities in each scenario. This evaluation study demonstrates the potential value of telemedicine use in rural emergency departments to patients, rural hospitals and rural communities.

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mentioning

confidence: 99%

Using Telemedicine to Avoid Transfer of Rural Emergency Department Patients

Hicks¹,

Boles²,

Hudson³

et al. 2001

The Journal of Rural Health

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Blood in Our Streets

Eastman

1992

Arch Surg

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Injury is our nation's leading public health problem. Victims of violence need expert and immediate medical attention. A model exists for optimal care of the injured patient--the trauma care, the components of the ideal, inclusive history of trauma care, the components of the ideal, inclusive trauma care system, its efficacy, and the challenges and opportunities facing those who advocate such systems.

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Possible Geographical Barriers to Trauma Center Access for Vulnerable Patients in the United States

Hsia

Shen²

2011

Arch Surg

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Objective To study whether traditionally vulnerable populations have worse geographic access to trauma centers. Design A cross-sectional analysis using data from the American Hospital Association Annual Survey from 2005 linked with zip code–level data from the US Census. We used a multinomial logit model to examine the odds of having difficult as opposed to easy access to trauma centers for a given subgroup of vulnerable populations. Setting and Participants Population in rural and urban communities as defined by zip codes in the United States. Main Outcome Measures Each community’s distance to the nearest trauma center (levels I–III). Results In urban areas, 67% of the population had easy access to trauma centers and 12% had difficult access compared with 24% and 31% in rural areas, respectively. Areas with higher shares of the following vulnerable population groups had higher risks (odds ratios) of facing difficult access to trauma center services in 2005: foreign born in urban areas (1.65 for a medium share and 2.18 for a high share [both P < .01]); African American in urban and rural areas (1.25 for a medium share and 1.35 for a high share, respectively [both P < .05]); and near-poor in urban and rural areas (1.52 [P < .05] and 1.69 [P < .01] for a high share, respectively). Conclusions A significant segment of the US population (representing 38.4 million people) does not have access to trauma care within 1 hour of driving time. Moreover, certain vulnerable groups are at higher risk than others for worse access to trauma centers. Stakeholders and health care planners should consider these factors in the development of trauma systems because a mismatch of potential need and access could signal inefficiencies in the delivery of care.

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An Analysis of the Critical Problem of Trauma Center Reimbursement

Cited by 51 publications

References 0 publications

Using Telemedicine to Avoid Transfer of Rural Emergency Department Patients

Using Telemedicine to Avoid Transfer of Rural Emergency Department Patients

Blood in Our Streets

Possible Geographical Barriers to Trauma Center Access for Vulnerable Patients in the United States

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