Trauma patients: you can get them in, but you can’t get them out

Abstract Background The majority of inpatient trauma care resources are consumed by a small proportion of severely injured patients. Methods Hospital lengths of stay (LOS), resource consumption, and postdischarge placement were abstracted from the institutional trauma registry. Results Patients (n =...

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Bibliographic Details
Published in:The American journal of surgery 2008, Vol.195 (1), p.78-83
Main Authors: Ciesla, David J., M.D, Sava, Jack A., M.D, Kennedy, Susan O, Levinson, Karen, M.S.W, Jordan, Marion H., M.D
Format: Article
Language:English
Subjects:
Adult
Aftercare - utilization
Biological and medical sciences
Cross-Sectional Studies
District of Columbia
Emergency services
Female
General aspects
Health Care Rationing - organization & administration
Health Resources - utilization
Hospitals
Humans
Intensive Care Units - utilization
Length of stay
Length of Stay - statistics & numerical data
Male
Medical sciences
Middle Aged
Patient Discharge - statistics & numerical data
Patients
Registries
Subacute Care
Surgery
Throughput
Time Factors
Trauma
Trauma centers
Trauma Centers - utilization
Trauma Severity Indices
Utilization Review
Wounds and Injuries - diagnosis
Wounds and Injuries - rehabilitation
Wounds and Injuries - therapy
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Summary:Abstract Background The majority of inpatient trauma care resources are consumed by a small proportion of severely injured patients. Methods Hospital lengths of stay (LOS), resource consumption, and postdischarge placement were abstracted from the institutional trauma registry. Results Patients (n = 4,070) were evaluated by the trauma service during the study period. The overall mean LOS was 4.4 days, and beds were occupied on 18,005 days. Two hundred forty-four (6%) patients remained in the hospital >14 days after injury and occupied beds on 8,560 (47%) days. These patients were older, more severely injured, and required proportionately more intensive care unit and operative care. Injuries to the head, abdomen, and extremities were independently associated with longer LOS. Most patients with longer LOS were placed in long-term acute care or received home nursing care after discharge. Conclusions Almost half of inpatient trauma bed-days are occupied by a small proportion of patients with long-term care needs.
ISSN:0002-9610
1879-1883
DOI:10.1016/j.amjsurg.2007.05.037