Ordog G J, Wasserberger J, Balasubramanium S, Shoemaker W
Department of Emergency Medicine, Martin Luther King, Jr. General Hospital, Los Angeles, CA.
J Trauma. 1994 Jan;36(1):106-11.
Cost containment is important in this time of inner-city economic and health-care crisis. Of 28,150 patients treated for gunshot wounds (GSWs) from 1977 through 1991, 16,892 (60%) were treated as outpatients after emergency department evaluation and treatment. The complication rate was 1.8% (mostly infections), and nine patients were later found to have vascular injuries requiring surgical treatment. These were identified later at outpatient follow-up and treated with no long-term morbidity or mortality. A conservative estimate of the cost savings from this study was more than $37 million. With a more liberal use of angiography to eliminate rare missed vascular injuries, many GSW victims can be safely treated as outpatients, eliminating the need for expensive in-hospital observation.
在当前市中心经济和医疗保健危机时期，成本控制至关重要。1977年至1991年期间，在28150例枪伤患者中，16892例（60%）在急诊科评估和治疗后作为门诊患者接受治疗。并发症发生率为1.8%（主要是感染），后来发现9例患者有需要手术治疗的血管损伤。这些损伤在门诊随访中后来被发现，并得到治疗，没有长期的发病率或死亡率。这项研究保守估计节省的成本超过3700万美元。通过更广泛地使用血管造影术来消除罕见的漏诊血管损伤，许多枪伤受害者可以安全地作为门诊患者治疗，从而无需进行昂贵的住院观察。
