TY  - JOUR
PY  - 2010//
TI  - The Association Between Cost and Quality in Trauma: Is Greater Spending Associated With Higher-Quality Care?
JO  - Annals of surgery
A1  - Glance, Laurent G.
A1  - Dick, Andrew W.
A1  - Osler, Turner M.
A1  - Meredith, William
A1  - Mukamel, Dana B.
SP  - 217
EP  - 222
VL  - 252
IS  - 2
N2  - 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>
LA  - en
SN  - 0003-4932
UR  - http://dx.doi.org/10.1097/SLA.0b013e3181e623f6
ID  - ref1
ER  -