The military health care system: providing quality care at a low per capita cost.

Orthopaedic trauma constitutes a significant portion of injuries in the military. By focusing on the "Quadruple Aim" of readiness, population health, experience of care, and per capita costs, the Military Health System delivers high-quality care with low costs. We examine the components of military health policy to find avenues of improvement for civilian orthopaedics. Greater emphasis on preventive medicine, alternative clinic structures, and interchangeability will help civilian orthopaedists lower costs and deliver quality patient-centered care similar to current military structure.

Trauma program development.

The development of a strong trauma program is clearly one of the most important facets of successful business development. Several recent publications have demonstrated that well run trauma services can generate significant profits for both the hospital and the surgeons involved. There are many aspects to this task that require constant attention and insight. Top notch patient care, efficiency, and cost-effective resource utilization are all important components that must be addressed while providing adequate physician compensation within the bounds of hospital financial constraints and the encompassing legal issues. Each situation is different but many of the components are universal. This chapter addresses all aspects of trauma program development to provide the graduating fellow with the tools to create a new trauma program or improve an existing program in order to provide the best patient care while optimizing financial reward and improving care efficiency.

A ten-year analysis of the research funding program of the orthopaedic trauma association.

BACKGROUND: The Orthopaedic Trauma Association (OTA) awarded over $3 million in research grants during 2000 through 2009. However, little is known regarding the outcomes of this funding program. Given the continued constraints in securing research dollars, we evaluated the research funding program of the OTA over this ten-year period. We studied the association of grant funding with (1) the publication rate, (2) the cost per publication, (3) the journal impact factor for published manuscripts, and (4) the dollar amount of extramural funding secured. METHODS: Grants from the target period were identified with use of the OTA online archive. The title of each grant and the name of the principal investigator were used to search across seven scientific databases for associated publications. RESULTS: Over the study period, $3,507,050 was awarded through 131 grants (thirty-three clinical, thirty-nine basic science, and fifty-nine resident). A total of 202 associated publications (seventy-three for the clinical grants, eighty-four for the basic science grants, and forty-five for the resident grants) were identified. Twenty-two (67%) of the clinical grants led to at least one publication compared with thirty-one (79%) of the basic science grants and twenty-four (41%) of the resident grants. The cost per publication was $26,892 for the clinical grants compared with $11,357 for the basic science grants and $13,111 for the resident grants. The mean impact factor of the journals containing the publications was 2.58. CONCLUSIONS: Over the study period, the publication output for the funded projects was substantial. Basic science grants had the highest publication rate. The three types of grants resulted in publication in peer-reviewed journals with similar impact factors.

Resources for your career in orthopaedic traumatology: what can the OTA do for you?

For those choosing a career in orthopaedic traumatology, several resources have been established by the Orthopaedic Trauma Association to facilitate progression from the years in training to the early years in practice. Young practitioners have access to educational programming, such as preparation for Part II of the Board Examination, web-based resources, such as on-line job postings, advocacy in health policy for the issues that will affect their ability to practice, and public relations efforts to increase their presence in the community. Ultimately, the resources set aside for the young practitioner by the Orthopaedic Trauma Association are intended to facilitate a sense of excellence, service, and community.