评估三级和四级创伤中心的创伤准备成本。
Assessing trauma readiness costs in level III and level IV trauma centers.
机构信息
From the Georgia Trauma Commission (E.V.A.), Madison; John D. Archbold Memorial Hospital (K.A.V.), Thomasville; Augusta University Health (R.S.M.), Augusta; Archbold Memorial Hospital (G.K.P.), Thomasville; Crisp Regional Medical Center (A.R.R.), Cordele; and Department of Surgery (D.W.A.), Atrium Health Navicent, Macon, Georgia.
出版信息
J Trauma Acute Care Surg. 2023 Feb 1;94(2):258-263. doi: 10.1097/TA.0000000000003842. Epub 2022 Nov 14.
BACKGROUND
Readiness costs are expenses incurred by trauma centers to maintain essential infrastructure. Although the components for readiness are described in the American College of Surgeons' Resources for Optimal Care of the Injured Patient , the cost associated with each component is not well defined. Previous studies describe readiness costs for levels I and II trauma centers based on these criteria. The purpose of this study was to quantify the cost of levels III and IV trauma center readiness.
METHODS
The state trauma commission, along with trauma medical directors, program managers, and trauma center financial staff, standardized definitions for each component of trauma center readiness costs and developed a survey tool for reporting. Readiness costs were grouped into four categories: Administrative/Program Support Staff, Clinical Medical Staff, and Education/Outreach. A financial auditor analyzed all data to verify consistent cost reporting. Trauma center outliers were evaluated to validate variances. All levels III and IV trauma centers (n = 14) completed the survey on 2019 data.
RESULTS
Average annual readiness cost is $1,715,025 for a level III trauma center and $81,620 for level IV centers. Among the costliest components were clinical medical staff for level IIIs and administrative costs for level IVs, representing 54% and 97% of costs, respectively. Although education/outreach is mandated, levels III and IV trauma centers only spend approximately $8,000 annually on this category (0.8-3%).
CONCLUSION
This study defines the cost associated with each readiness component outlined in the Resources for Optimal Care of the Injured Patient manual. The average readiness cost for a level III trauma center is $1,715,025 and $81,620 for a level IV, underscoring the need for additional trauma center funding to meet the requirements set forth by the American College of Surgeons.
LEVEL OF EVIDENCE
Economic and Value-Based Evaluations; Level III.
背景
准备成本是创伤中心为维持基本基础设施而产生的费用。尽管《美国外科医师学院创伤患者最佳护理资源》中描述了准备的组成部分，但与每个组成部分相关的成本并未明确定义。以前的研究根据这些标准描述了 I 级和 II 级创伤中心的准备成本。本研究的目的是量化 III 级和 IV 级创伤中心准备成本。
方法
州创伤委员会与创伤医学主任、项目管理人员和创伤中心财务人员一起，对创伤中心准备成本的每个组成部分的定义进行了标准化，并制定了报告工具。准备成本分为四类：行政/项目支持人员、临床医务人员和教育/外展。财务审计员分析了所有数据，以验证一致的成本报告。评估了创伤中心的异常值，以验证差异。所有三级和四级创伤中心（n=14）都在 2019 年完成了调查。
结果
三级创伤中心的年平均准备成本为 1,715,025 美元，四级中心为 81,620 美元。最昂贵的组成部分是三级创伤中心的临床医务人员和四级创伤中心的行政费用，分别占成本的 54%和 97%。尽管教育/外展是强制性的，但三级和四级创伤中心每年仅在这一类别上花费约 8,000 美元（0.8-3%）。
结论
本研究定义了《美国外科医师学院创伤患者最佳护理资源》手册中概述的每个准备组成部分的相关成本。三级创伤中心的平均准备成本为 1,715,025 美元，四级为 81,620 美元，这突显了需要额外的创伤中心资金来满足美国外科医师学院规定的要求。
证据水平
经济和基于价值的评估；III 级。
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