Pediatric trauma center verification improves quality of care and reduces resource utilization in blunt splenic injury
jpedsurg.org shows its articles on its own site.
Read the article on jpedsurg.org ↗Article · Oct 2018 · 1 min read
In brief
In brief
This retrospective study demonstrates that pediatric trauma center verification significantly improves care quality and reduces costs for children with blunt splenic injuries, particularly those with multisystem trauma. The transition from adult to verified pediatric trauma center was associated with decreased operative rates and hospital charges while maintaining quality outcomes.
Written by the GCMD Library team from the article.
Purpose
We sought to evaluate value impact of transition from an adult trauma center treating children (ATC) to a verified pediatric trauma center (PTC) in children with blunt splenic injury (BSI).
Methods
Children with BSI from FY 2005 to FY 2017 were extracted from the hospital trauma registry. February 2009 distinguished "ATC" treated children from "PTC" treated children. Cohorts were subcategorized into "isolated injury" and "multisystem injury". Quality and financial characteristics were statistically compared. Analysis of covariance was used to evaluate changes in quality and financial trends over the transition period. A multiple linear regression was performed to identify variables independently predictive of hospital and professional charges.
Results
126 children with BSI were identified (ATC, n = 56; PTC, n = 70). Splenic procedure rates and hospital charges decreased. Quality and cost metrics for isolated BSI remained unchanged while multisystem BSI children experienced improvements. PTC designation, ISS, splenic procedure, isolated BSI, average hospital LOS, and mortality were all independently predictive of hospital and professional charges.
Conclusions
PTC verification improves the value of BSI management, but the associated decrease in operative rate is only partially responsible. Multisystem injury children experience the greatest value benefit from PTC verification.
Type of study
Treatment and cost-effectiveness study.
Level of evidence
Level III.