@article{ref1,
title="The Association Between Cost and Quality in Trauma: Is Greater Spending Associated With Higher-Quality Care?",
journal="Annals of surgery",
year="2010",
author="Glance, Laurent G. and Dick, Andrew W. and Osler, Turner M. and Meredith, William and Mukamel, Dana B.",
volume="252",
number="2",
pages="217-222",
abstract="OBJECTIVE: To examine the association between trauma center quality and costs. BACKGROUND: Current efforts to reduce health care costs and improve health care quality require a better understanding of the relationship between cost and quality. METHODS: Using data from the Healthcare Cost and Utilization Projects Nationwide Inpatient Sample, we performed a retrospective observational study of 67,124 trauma patients admitted to 73 trauma centers. Generalized linear models were used to explore the association between hospital cost and in-hospital mortality, controlling for hospital and patient factors as follows: injury diagnoses, age, gender, mechanism of injury, comorbidities, teaching status, hospital ownership, geographic region, and hospital wages. RESULTS: Patients treated in hospitals with low risk-adjusted mortality rates had significantly lower costs than those treated in average-quality hospitals. The relative cost of patients treated in high-quality hospitals was 0.78 (95% confidence interval: 0.64, 0.95) compared with average-quality hospitals. The cost of treating patients in average- and high-mortality trauma centers was similar. CONCLUSION: In this study based on the Healthcare Cost and Utilization Project Nationwide Inpatient Sample, the care of injured patients is less expensive in hospitals with lower risk-adjusted mortality rates. Hospitals with low risk-adjusted mortality rates have adjusted mortality rates that are 34% lower while spending nearly 22% less compared with average-quality hospitals.<p /> <p>Language: en</p>",
language="en",
issn="0003-4932",
doi="10.1097/SLA.0b013e3181e623f6",
url="http://dx.doi.org/10.1097/SLA.0b013e3181e623f6"
}