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Restorative care is provided once a patient has been discharged from a healthcare facility and requires additional services. The additional services include home care, rehabilitation programs, and extended care. Restorative care centers help the patient regain their previous level of functioning or acquire a new level of functioning due to the incapacitating effects of a disease or a disability. It aims to assist patients in enhancing their quality of life by encouraging independence,...
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Trauma Program Value Assessment at an Academic Health Network System Over 12 Years.

Michael Abdelmasseh1, Araceli Cuaranta1, Errington Thompson1

  • 1Department of Surgery and Marshall Institute for Interdisciplinary Research (MIIR), Marshall University School of Medicine, Huntington, WV, USA.

The American Surgeon
|June 6, 2024
PubMed
Summary
This summary is machine-generated.

Trauma care for urgent laparotomies and thoracotomies shows high value, with above-average outcomes despite longer lengths of stay. Protocols are being developed to reduce hospital stays for trauma patients.

Keywords:
laparotomyqualitysurgical outcomesthoracotomyvalue

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Area of Science:

  • Trauma Surgery
  • Health Services Research
  • Value-Based Care

Background:

  • Trauma is a significant cause of death and injury globally, necessitating effective care strategies.
  • Urgent surgical interventions like laparotomy (LAP) and thoracotomy (THO) are critical for severe trauma cases.
  • Assessing the value of trauma care is essential for improving patient outcomes and resource allocation.

Purpose of the Study:

  • To evaluate the value of trauma care for patients undergoing urgent laparotomies and thoracotomies within a specific Health Network System.
  • To analyze quality and cost domains associated with trauma surgical procedures.
  • To compare observed outcomes against expected outcomes using established risk calculators.

Main Methods:

  • Retrospective and prospective data collection of clinical variables (n=84) for trauma patients over 11 years.
  • Categorization of patients based on Injury Severity Score (ISS): mild/moderate (ISS <15) and severe (ISS >15).
  • Assessment of value using quality metrics (postoperative complications, length of stay, readmissions, patient satisfaction) and cost metrics (total charges, reimbursement index).

Main Results:

  • Out of 16,044 trauma admissions, 528 (3.2%) required urgent LAP (n=413) or THO (n=115).
  • Multivariate analysis identified ISS, age, ASA class, and medical center as predictors of postoperative complications.
  • Postoperative complication rates were favorable, but length of stay exceeded national averages.

Conclusions:

  • The trauma program demonstrates high value within the Health Network System.
  • Strategies to reduce length of stay are being implemented to further enhance care value.
  • Continued evaluation of quality and cost metrics is crucial for optimizing trauma care delivery.