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Trauma care costs highest in West, but higher costs do not equal better survival
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Trauma care in the Western part of the United States is more expensive than for patients in other parts of the country, although survival rates in all parts of the country remain the same, according to researchers at Johns Hopkins University School of Medicine.
“Spending more does not always mean saving more lives,” Adil H. Haider, MD, MPH, associate professor of surgery at Johns Hopkins University School of Medicine, stated in a press release. “If doctors in the Northeast do things more economically and with good results, why cannot doctors out west do the same thing? This study provides a potential road map for cutting unnecessary costs without hurting outcomes.”
Haider and the researchers sifted through 3 years worth of data from the Healthcare Cost and Utilization Project’s Nationwide Inpatient Sample and found 62,768 adult patients with five different traumatic injuries including: blunt spleen injury, collapsed lung and bleeding in the chest, tibia fracture, mild traumatic brain injury and liver injury. Potential biases included injury severity, presence of chronic illnesses and variations in prices for health care.
The estimated cost for all five injuries combined in the Northeast was $14,022, the researchers stated. The costs were 18% higher in the South, 22% higher in the Midwest and 33% higher in the West. The cost of liver injury was the highest at $16,213 in the Northeast. This cost was estimated at 18% higher in the South, 22% higher in the Midwest and 35% higher in the West. However, the Northeast showed the lowest costs for each type of injury, while the West had the highest.
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Haider warned that surgeons should look for other outcomes beyond survival to make certain the more expensive care would not be better.
“If surgeons are fixing tibia fractures in the West in a way that is more expensive, but makes patients more comfortable, that would not be a trivial finding,” Haider stated. “We really need to drill down and figure out what parts of care improve outcomes and what parts drive up costs without improving any outcomes or aspects of care important to patients.”
Reference:
Obirieze AC, Gaskin, DJ, Villegas CV, et al. Regional variations in cost of trauma care in the United States: Who is paying more? J Trauma Acute Care Surg. 2012; 73(2): 516-522. doi: 10.1097/TA.0b013e31825132a0.
