Injuries are the leading cause of death for Americans between the ages of 1 and 44, according to the Centers for Disease Control and Prevention. Given that fact, it is understandable that EMS personnel — especially air medical services — look for the nearest trauma center when creating a transportation and treatment plan. But is this always the best choice?
It is clear the future of healthcare lies in silos — the establishment of facilities and practices that focus on a specific medical niche. The number of treatment options is expanding even further to include heart hospitals, neurosurgical centers, neonatal units and orthopedic specialists. A recent study by the Oregon Health and Science University took a close look at how opting to transport accident victims to a designated trauma center affects the healthcare bottom line.
Cost of EMS
The National Highway Traffic Safety Administration reports that EMS create a widely distributed economic burden on the healthcare system. More than $2.5 billion of Medicare goes into patient transportation, for example.
Not all of this involves trauma transports, obviously, but the study conducted by Oregon Health and Science University indicates that taking victims to a major trauma center when a mainstream emergency room is adequate adds to that burden.
Since the silos continue to grow, now is the time for the clinical aviation community to scrutinize the financial side of transportation to specialty centers.
A Look at the Study
The researchers in Oregon monitored seven western metropolitan areas over three years to evaluate transportation protocols to trauma centers. During this time, they established 85,000 victims ended up at a major trauma center unnecessarily. These choices cost the healthcare industry an estimated $130 million each year.
The researchers found that of the 301,000 cases examined by the committee, 248,000 of them were low-risk injuries that did not need the specialty care of a trauma center, yet about one-third of those individuals ended up there.
The agencies included in the study used national trauma triage guidelines to establish the need of each injured party to get specialized treatment. Since that is the basic practice for most EMS, the conclusion is this sampling offers a good representation of what is happening across the country. The study shows these choices influence the cost of EMS, so prehospital care decisions escalate the overall treatment expense.
Why Treatment Faculty Choices Matter
The bottom line is specialized medical care is not the most cost-effective approach to treatment. A Level-1 trauma center offers the most advanced care options for patients with life-threatening injuries. While this is necessary for major traumas, it does come at a cost. The Oregon study concluded that treatment at a Level-1 center costs patients $5,590 more that a non-trauma unit.
You might argue that patients with minor injuries who end up at a major trauma center require less care, so the cost balances out. The researchers found this to be untrue, as well. Even minor treatment at a Level-1 facility increased the final care expense by almost $5,000.
The medical community and federal government are looking for ways to cut back on the waste in healthcare practice. With more specialty facilities popping up all the time, flight nurses, doctors and air medics will face even more decision-making challenges. Although patient care and treatment outcomes are what matters, air medical services cant afford to dismiss the cost factor when making transport choices not when the wrong ones are adding millions of dollars to the cost burden of EMS.
