How much green does it take to be orange? Determining the cost associated with trauma center readiness

被引：28

作者：

Ashley, Dennis W. ^{[1
]}

Mullins, Robert F. ^{[2
]}

Dente, Christopher J. ^{[3
]}

Johns, Tracy J. ^{[1
]}

Garlow, Laura E. ^{[4
]}

Medeiros, Regina S. ^{[5
]}

Atkins, Elizabeth V. ^{[3
]}

Solomon, Gina ^{[6
,18
]}

Abston, Dena ^{[7
]}

Ferdinand, Colville H. ^{[8
]}

Bhatia, Amina ^{[9
]}

Hill, Karen ^{[9
]}

Rhee, Peter ^{[10
]}

Atkins, Elizabeth ^{[10
]}

Ashley, Dennis ^{[11
]}

Johns, Tracy ^{[11
]}

Dunne, James ^{[12
]}

Armola, Rochelle ^{[12
]}

Ferdinand, Colville ^{[13
]}

Medeiros, Regina ^{[13
]}

Wyrzkowski, Amy ^{[14
]}

Sargent, Jim ^{[14
]}

Cascone, John ^{[15
]}

Stitely, Daphne ^{[15
]}

Bleacher, John ^{[16
]}

Walton, Tracie ^{[16
]}

McKemie, Clarence ^{[17
]}

Parris, Melissa ^{[17
]}

Massoud, Romeo ^{[18
]}

Nicholas, Jeffrey ^{[18
]}

Paynter, Steven ^{[19
]}

Brown, Kim ^{[19
]}

Hannay, Scott ^{[20
]}

Baggett, Leslie ^{[20
]}

Creel, Nathan ^{[21
,22
]}

Gibson, Jesse ^{[21
,22
]}

Hawk, Thomas ^{[22
]}

Morgan, Heather ^{[22
]}

Renz, Barry ^{[23
]}

Garlow, Laura ^{[23
]}

Gravlee, Mark ^{[24
]}

Mardhekar, Aruna ^{[24
]}

Postoev, Angelina ^{[25
]}

Cox, Melanie ^{[25
]}

Mayfield, Kelly ^{[26
]}

Carnes, Jaina ^{[26
]}

Campbell, Robert ^{[27
]}

Jones, Alex ^{[27
]}

Scheirer, Robert ^{[28
]}

Mercer, Misty ^{[28
]}

机构：

[1] Navicent Hlth, Med Ctr, Dept Surg, Box 140,777 Hemlock St, Macon, GA 31201 USA

[2] Still Burn Ctr, Augusta, GA USA

[3] Emory Univ, Grady Mem Hosp, Atlanta, GA 30322 USA

[4] Wellstar Kennestone Hosp, Kennestone, GA USA

[5] Augusta Univ Hlth, Augusta, GA USA

[6] Gwinnett Med Ctr, Lawrenceville, GA USA

[7] Georgia Trauma Commiss, Augusta, GA USA

[8] Doctors Hosp, Augusta, GA USA

[9] Childrens Healthcare Atlanta Egleston, Atlanta, GA USA

[10] Grady Hlth Syst, Atlanta, GA USA

[11] Navicent Hlth, Med Ctr, Macon, GA USA

[12] Mem Hlth Univ Med Ctr, 4700 Waters Ave, Savannah, GA 31404 USA

[13] Univ Healthcare Syst, Augusta, GA USA

[14] Wellstar Atlanta Med Ctr, Atlanta, GA USA

[15] Archbold Mem Hosp, Thomasville, GA USA

[16] Childrens Healthcare Atlanta Scottish Rite, Atlanta, GA USA

[17] Floyd Med Ctr, Rome, GA USA

[18] Gwinnett Med Ctr, Lawrenceville, GA USA

[19] Hamilton Med Ctr, Dalton, GA USA

[20] Midtown Med Ctr, Columbus, GA USA

[21] Northeast Georgia Med Ctr, Gainesville, GA USA

[22] Piedmont Athens Reg Med Ctr, Athens, GA USA

[23] WellStar Kennestone Hosp, Marietta, GA USA

[24] WellStar North Fulton Hosp, Roswell, GA USA

[25] Clearview Reg Med Ctr, Monroe, GA USA

[26] Redmond Reg Med Ctr, Rome, GA USA

[27] Taylor Reg Hosp, Hawkinsville, GA USA

[28] Trinity Hosp Augusta, Augusta, GA USA

[29] Crisp Reg Hosp, Cordele, GA USA

[30] Effingham Hlth Syst, Springfield, GA USA

[31] Emanuel Med Ctr, Swainsboro, GA USA

[32] Meadows Reg Med Ctr, Vidalia, GA USA

[33] Morgan Mem Hosp, Madison, GA USA

[34] Grady Burn Ctr, Atlanta, GA USA

[35] Joseph M Still Burn Ctr, Augusta, GA USA

[36] Off Emergency Med Serv & Trauma, Atlanta, GA USA

[37] Georgia Trauma Care Network Commiss, Rossville, GA USA

来源：

JOURNAL OF TRAUMA AND ACUTE CARE SURGERY | 2019年 / 86卷 / 05期

关键词：

Readiness costs; trauma center; survey;

D O I：

10.1097/TA.0000000000002213

中图分类号：

R4 [临床医学];

学科分类号：

1002 ; 100602 ;

摘要：

BACKGROUND: Readiness costs are real expenses incurred by trauma centers to maintain essential infrastructure to provide emergent services on a 24/7 basis. Although the components for readiness arewell 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. We hypothesized thatmeeting the requirements of the 2014 Resources for Optimal Care of the Injured Patient would result in significant costs for trauma centers. METHODS: The state trauma commission in conjunction with trauma medical directors, program managers, and financial officers of each trauma center standardized definitions for each component of trauma center readiness cost and developed a survey tool for reporting. Readiness costs were grouped into four categories: administrative/program support staff, clinical medical staff, in-house operating room, and education/outreach. To verify consistent cost reporting, a financial auditor analyzed all data. Trauma center outliers were further evaluated to validate variances. All level I/level II trauma centers (n = 16) completed the survey on 2016 data. RESULTS: Average annual readiness cost is US $ 10,078,506 for a level I trauma center and US $ 4,925,103 for level IIs. Clinical medical staffwas the costliest component representing 55% of costs for level Is and 64% for level IIs. Although education/outreach is mandated, levels I and II trauma centers only spend approximately US $ 100,000 annually on this category (1%-2%), demonstrating a lack of resources. CONCLUSION: This study defines the cost associated with each component of readiness as defined in the Resources for Optimal Care of the Injured Patient manual. Average readiness cost for a level I trauma center is US $ 10,078,506 and US $ 4,925,103 for a level II. The significant cost of trauma center readiness highlights the need for additional trauma center funding to meet the requirements set forth by the American College of Surgeons. Copyright (c) 2019 American Association for the Surgery of Trauma.

引用

页码：765 / 773

页数：9

共 8 条

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