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The Effect of Joining the ASSH Hand Trauma Center Network on the Volume and Severity of Pediatric Hand Trauma
Ebubechi Adindu1, Bryan Head1,2, Bryce Bell1,2
1Baylor College of Medicine, Houston, TX.
Insights
Joining the American Society for Surgery of the Hand Trauma Center Network increased pediatric hand trauma case volume by 10-60%. Trauma severity remained unchanged, but insurance demographics shifted.
Area of Science:
- Pediatric Trauma Surgery
- Hand Surgery
- Health Services Research
Background:
- The American Society for Surgery of the Hand (ASSH) established a Trauma Center Network to standardize care for severe hand injuries.
- Understanding the impact of network participation on patient volume and demographics is crucial for resource allocation.
Purpose of the Study:
- To evaluate the effect of ASSH Trauma Center Network enrollment on the volume and severity of pediatric hand trauma.
- To analyze changes in patient demographics and insurance status post-enrollment.
Main Methods:
- Retrospective review of a level-I pediatric trauma center's patient database from February 2018 to January 2022.
- Comparison of monthly transfer volume, Injury Severity Score (ISS), and quarterly payor status before (pre-February 2019) and after (post-February 2019) ASSH network enrollment.
Main Results:
- A significant increase in the average monthly volume of pediatric hand trauma transfers was observed after joining the ASSH network.
- The proportion of patients with commercial insurance increased post-enrollment, while the proportion with Medicaid decreased.
- No significant change in the Injury Severity Score (ISS) was noted, indicating consistent trauma severity.
Conclusions:
- Institutions joining the ASSH Trauma Center Network can anticipate a 10% to 60% rise in pediatric hand trauma cases.
- The severity of these trauma cases is unlikely to change significantly after network affiliation.
- Network participation influences patient volume and insurance demographics, necessitating proactive resource planning.
Purpose:
The purpose of our study was to evaluate how the volume and severity of pediatric hand trauma is affected after enrollment into the American Society for Surgery of the Hand Trauma Center Network.
Methods:
We performed a retrospective review using the patient database from our affiliated level-I pediatric trauma center. With this patient database, we compiled all emergent hand trauma transfers from February 2018 to January 2022. We compared the monthly volume, Injury Severity Score, and quarterly payor status between hand trauma transfer patients before and after enrollment into the Hand Trauma Center Network in February 2019.
Results:
The average number of monthly transfers increased after joining the Hand Trauma Center Network compared with the years after February 2019. Additionally, the percentage of patients using commercial insurance increased after joining the Hand Trauma Center Network when compared with that before February 2019. Lastly, the percentage of patients using Medicaid decreased after February 2019.
Conclusions:
Based on our findings, we believe that new institutions and providers can expect anywhere from a 10% to a 60% increase in hand trauma burden without a significant change in the severity of the trauma cases after joining the network.
Type Of Study/Level Of Evidence:
Prognostic IV.
