Frequency and costs of laboratory and radiograph repetition in trauma patients undergoing interfacility transfer

Receiving trauma centers often duplicate laboratory and radiograph testing performed by referring institutions. Our objective was to quantify frequency and costs of this practice. In this prospective study of 104 consecutive interfacility-transported adult trauma patients flown by an emergency medic...

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Bibliographic Details
Published in:The American journal of emergency medicine 2000-03, Vol.18 (2), p.156-158
Main Authors: Thomas, Stephen H, Orf, Janet, Peterson, Chad, Wedel, Suzanne K
Format: Article
Language:English
Subjects:
Adult
Air Ambulances
Biological and medical sciences
Chi-Square Distribution
Emergency Service, Hospital - economics
Health Services Research
Hospital Costs - statistics & numerical data
Humans
Laboratories, Hospital - economics
Laboratories, Hospital - statistics & numerical data
laboratory repetition
Massachusetts
Medical sciences
Miscellaneous
Multiple Trauma - blood
Multiple Trauma - diagnostic imaging
Patient Transfer - economics
Prospective Studies
radiograph repetition
Radiography - economics
Radiography - statistics & numerical data
Referral and Consultation - economics
Referral and Consultation - statistics & numerical data
Trauma Centers - economics
Trauma workup
Traumas. Diseases due to physical agents
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Summary:Receiving trauma centers often duplicate laboratory and radiograph testing performed by referring institutions. Our objective was to quantify frequency and costs of this practice. In this prospective study of 104 consecutive interfacility-transported adult trauma patients flown by an emergency medical service to an urban level I center, flight crew noted which labs and radiographs were done at referring hospitals, which tests were sent with patients, and which were repeated on trauma center arrival. Overall, results from 246 of 283 (86.9%) laboratory tests and 241 of 249 (96.8%) radiographs done at referring hospitals were sent with patients. Repetition of laboratory tests at the receiving hospital was frequent regardless of whether initial results were sent ( P = .6 by χ 2), and radiograph repetition was unrelated to whether sent films were originals or copies ( P = .2 by χ 2). For these 104 patients, the receiving hospital charged $66,463 for repetition of work-up done at referring facilities.
ISSN:0735-6757
1532-8171
DOI:10.1016/S0735-6757(00)90008-1