Does the Halo Effect for Level 1 Trauma Centers Apply to High-Acuity Nonsurgical Admissions?
J Am Osteopath Assoc
; 120(5): 303-309, 2020 May 01.
Article
em En
| MEDLINE
| ID: mdl-32337565
ABSTRACT
CONTEXT The halo effect describes the improved surgical outcomes at trauma centers for nontrauma conditions. OBJECTIVE:
To determine whether level 1 trauma centers have improved inpatient mortality for common but high-acuity nonsurgical diagnoses (eg, acute myocardial infarction [AMI], congestive heart failure [CHF], and pneumonia [PNA]) compared with non--level 1 trauma centers.METHODS:
The authors conducted a population-based, retrospective cohort study analyzing data from the Healthcare Cost and Utilization Project State Inpatient Database and the American Hospital Association Annual Survey Database. Patients who were admitted with AMI, CHF, and PNA between 2006-2011 in Florida and California were included. Level 1 trauma centers were matched to non-level 1 trauma centers using propensity scoring. The primary outcome was risk-adjusted inpatient mortality for each diagnosis (AMI, CHF, or PNA).RESULTS:
Of the 190,474 patients who were hospitalized for AMI, CHF, or PNA, 94,037 patients (49%) underwent treatment at level 1 trauma centers. The inpatient mortality rates at level 1 trauma centers vs non-level 1 trauma centers for patients with AMI was 8.10% vs 8.40%, respectively (P=.73); for patients with CHF, 2.26% vs 2.71% (P=.90); and for patients with PNA, 2.30% vs 2.70% (P=.25).CONCLUSION:
Level 1 trauma center designation was not associated with improved mortality for high-acuity, nonsurgical medical conditions in this study.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Centros de Traumatologia
/
Insuficiência Cardíaca
Tipo de estudo:
Observational_studies
Limite:
Humans
País/Região como assunto:
America do norte
Idioma:
En
Revista:
J Am Osteopath Assoc
Ano de publicação:
2020
Tipo de documento:
Article