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The impact of teaching status on trauma center clinical outcomes in the United States.
Elkbuli, Adel; Dowd, Brianna; Flores, Rudy; Boneva, Dessy; McKenney, Mark.
Afiliação
  • Elkbuli A; Department of Surgery, Kendall Regional Medical Center, Miami.
  • Dowd B; Department of Surgery, Kendall Regional Medical Center, Miami.
  • Flores R; Hospital Corporation of America, South Atlantic Division, Charleston, SC.
  • Boneva D; Department of Surgery, Kendall Regional Medical Center, Miami.
  • McKenney M; University of South Florida, Tampa, FL.
Medicine (Baltimore) ; 98(34): e16951, 2019 Aug.
Article em En | MEDLINE | ID: mdl-31441892
Teaching status/academic ranking may play a role in the variations in trauma center (TC) outcomes. Our study aimed to determine the relationship between TC teaching status and injury-adjusted, all-cause mortality in a national sampling.Retrospective review of the National Sample Program (NSP) from the National Trauma Data bank (NTDB). TCs were categorized based on teaching status. Adjusted mortality was determined by observed/expected (O/E) mortality ratios, derived using TRauma Injury Severity Score methodology from the Injury Severity Score and Revised Trauma Score. Chi-square and t test analyses were utilized with a statistical significance defined as P <.05.Of the 94 TCs in the NSP, 46 were university, 38 were community teaching, and 10 were community nonteaching. For the University TCs, 62.8% were American College of Surgeons (ACS) level 1 and 81.2% state level 1. Of the community teaching TCs, 39.0% was ACS level 1 and 35.1% was state level 1. Of the community nonteaching TCs, 0% was ACS level 1 and 11.1% was state level 1. University TCs had a significantly higher O/E mortality rate than community teaching (0.75 vs 0.71; P = .04). There were no differences in O/E between community teaching and nonteaching TCs (0.71 vs 0.70; P = .70).Community teaching and nonteaching TCs have lower injury-adjusted, all-cause mortality rates than University Centers. Future studies should further investigate key differences between University TCs and community teaching TC to evaluate possible quality and performance improvement measures.
Assuntos

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Centros de Traumatologia / Ferimentos e Lesões / Avaliação de Resultados em Cuidados de Saúde / Hospitais Comunitários / Hospitais Universitários Tipo de estudo: Observational_studies Limite: Adult / Female / Humans / Male País como assunto: America do norte Idioma: En Ano de publicação: 2019 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Centros de Traumatologia / Ferimentos e Lesões / Avaliação de Resultados em Cuidados de Saúde / Hospitais Comunitários / Hospitais Universitários Tipo de estudo: Observational_studies Limite: Adult / Female / Humans / Male País como assunto: America do norte Idioma: En Ano de publicação: 2019 Tipo de documento: Article