TY  - BOOK
AU  - Desale, Sameer
AU  - Hafiz, Shabnam
AU  - Sava, Jack
TI  - The impact of solid organ injury management on the US health care system
SN  - 2163-0755
KW  - *Health Expenditures/sn [Statistics & Numerical Data]
KW  - *Liver/in [Injuries]
KW  - *Spleen/in [Injuries]
KW  - Adult
KW  - Female
KW  - Health Care Costs/sn [Statistics & Numerical Data]
KW  - Hospital Costs/sn [Statistics & Numerical Data]
KW  - Humans
KW  - Length of Stay/ec [Economics]
KW  - Length of Stay/sn [Statistics & Numerical Data]
KW  - Male
KW  - Retrospective Studies
KW  - United States/ep [Epidemiology]
KW  - MedStar Heart & Vascular Institute
KW  - MedStar Washington Hospital Center
KW  - Surgery/Trauma Surgery
KW  - Journal Article
KW  - Research Support, Non-U.S. Gov't
N1  - Available online from MWHC library: 1995 - present, Available in print through MWHC library: 1999 - 2006
N2  - BACKGROUND: Since the 1980s, there has been a paradigm shift toward nonoperative management of stable patients with solid organ injury. The impact of this practice 141111 on national health care expenditure has not been well characterized; CONCLUSION: The trend toward nonoperative management of solid organ injury has resulted in a substantial decrease in health care expenditure and LOS while improving mortality for high-risk patients. Advances in trauma care can have significant impact on the cost of health care; LEVEL OF EVIDENCE: Economic analysis, level III; METHODS: Hospital discharge data from the Healthcare Cost Utilization Project Nationwide Inpatient Sample from every other year spanning 1994 to 2010 were studied using patients with a primary diagnosis of splenic and liver injury. Cost analysis was performed using cost-to-charge ratios, where actual costs of hospitalization with current management practices were compared with theoretical costs projecting 1994 practice patterns. Length of stay (LOS) was evaluated similarly to costs. Mortality risk was established using the validated Trauma Mortality Prediction Model; RESULTS: Data from 29,409 adult patients with splenic injury and 14,704 with liver injury were used for cost and LOS analysis. The proportion of patients undergoing nonoperative management increased from 38% to 67% for splenic injury and from 62% to 81% for liver injury. The mean cost for splenic injury dropped by
UR  - http://dx.doi.org/10.1097/TA.0000000000000291
ER  -