In a Mature Trauma System, There Is No Difference in Outcome (Survival) Between Level I and Level II Trauma Centers

Rogers, Frederick B.; Osler, Turner M.; Lee, John C.; Sakorafas, Lois; Wu, Daniel; Evans, Tracy; Edavettal, Mathew; Horst, Michael

doi:10.1097/ta.0b013e3182183789

Cited by 26 publications

(16 citation statements)

References 15 publications

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“…It is important for leaders to evaluate the maturation process within a trauma system (Rogers et al . ). In view of our finding, it may be reasonable to justify more demanding and costly criteria required for ACS designation of level I trauma centres.…”

Section: Discussionmentioning

confidence: 97%

Relationship of trauma centre characteristics and patient outcomes: a systematic review

Kim

2013

Journal of Clinical Nursing

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Section: Discussionmentioning

confidence: 97%

Relationship of trauma centre characteristics and patient outcomes: a systematic review

Kim

2013

Journal of Clinical Nursing

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“…Steps to insure data quality in the PTOS registry include the use of standard abstraction software with automatic data checks, a data definition manual, and internal and external data auditing (Rogers et al. ).…”

Section: Methodsmentioning

confidence: 99%

Trends in Racial Disparities for Injured Patients Admitted to Trauma Centers

Glance

Osler

Mukamel

et al. 2013

Health Services Research

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Objective. To determine whether outcome disparities between black and white trauma patients have decreased over the last 10 years. Data Source. Pennsylvania Trauma Outcome Study. Study Design. We performed an observational cohort study on 191,887 patients admitted to 28 Level 1 and Level II trauma centers. The main outcomes of interest were (1) death, (2) death or major complication, and (3) failure-to-rescue. Hospitals were categorized according to the proportion of black patients. Multivariate regression models were used to estimate trends in racial disparities and to assess whether the source of racial disparities was within or between hospitals. Principal Findings. Trauma patients admitted to hospitals with high concentrations of blacks (>20 percent) had a 45 percent higher odds of death (adj OR: 1.45, 95 percent CI: 1.09-1.92) and a 73 percent higher odds of death or major complication (adj OR: 1.73, 95 percent CI: 1.42-2.11) compared with patients admitted to hospitals treating low proportions of blacks. Blacks and whites admitted to the same hospitals had no difference in mortality (adj OR: 1.05, 95 percent CI: 0.87, 1.27) or death or major complications (adj OR: 1.01; 95 percent CI: 0.90, 1.13). The odds of overall mortality, and death or major complications have been reduced by 32 percent (adj OR: 0.68; 95 percent CI: 0.54-0.86) and 28 percent (adj OR: 0.72; 95 percent CI: 0.60-0.85) between 2000 and 2009, respectively. Racial disparities did not change over 10 years. Conclusion. Despite the overall improvement in outcomes, the gap in quality of care between black and white trauma patients in Pennsylvania has not narrowed over the last 10 years. Racial disparities in trauma are due to the fact that black patients are more likely to be treated in lower quality hospitals compared with whites. Key Words. Race, disparities, trauma Ethnic and racial disparities in health care quality are widespread and have been extensively documented. The age-adjusted mortality rate for black men is 19 percent higher than for white men (Gornick et al. 1996). Blacks are less likely to receive recommended care for acute myocardial infarctions (Cohen et al. 2010); pneumonia (Hausmann et al. 2009); hip fractures (Neuman et al.

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“…Data quality is assured through the use of standard abstraction software with automatic data checks, a data definition manual, and internal and external data auditing. 11…”

Section: Data Sourcementioning

confidence: 99%

Outcomes of Adult Trauma Patients Admitted to Trauma Centers in Pennsylvania, 2000-2009

Glance¹,

Osler²,

Mukamel³

et al. 2012

Arch Surg

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To examine longitudinal trends in mortality for injured patients admitted to trauma centers. Design, Setting, and Participants: Retrospective cohort design of 208 866 patients admitted to level I or level II trauma centers in Pennsylvania between 2000 and 2009 using the Pennsylvania Trauma Outcome Study database. Multivariate logistic regression was used to estimate the temporal trend for in-hospital mortality. Main Outcome Measures: Patients were stratified by injury severity to estimate mortality trends in patients with low-severity, moderate, severe, and very severe injuries.

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In a Mature Trauma System, There Is No Difference in Outcome (Survival) Between Level I and Level II Trauma Centers

Cited by 26 publications

References 15 publications

Relationship of trauma centre characteristics and patient outcomes: a systematic review

Relationship of trauma centre characteristics and patient outcomes: a systematic review

Trends in Racial Disparities for Injured Patients Admitted to Trauma Centers

Outcomes of Adult Trauma Patients Admitted to Trauma Centers in Pennsylvania, 2000-2009

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