TY  - JOUR
PY  - 2017//
TI  - Does the institution of a statewide trauma system reduce preventable mortality and yield a positive return on investment for taxpayers?
JO  - Journal of the American Academy of Surgeons
A1  - Maxson, Todd
A1  - Mabry, Charles D.
A1  - Sutherland, Michael J.
A1  - Robertson, Ronald D.
A1  - Booker, James O.
A1  - Collins, Terry
A1  - Spencer, Horace J.
A1  - Rinker, Charles F.
A1  - Sanddal, Teri L.
A1  - Sanddal, Nels D.
SP  - 489
EP  - 499
VL  - 224
IS  - 4
N2  - BACKGROUND: In July 2009, Arkansas began to annually fund $20 million for a statewide trauma system (TS). We studied injury deaths both pre-TS (2009) and post-TS (2013 to 2014), with attention to causes of preventive mortality, societal cost of those preventable mortality deaths, and benefit to tax payers of the lives saved. STUDY DESIGN: A multi-specialty trauma-expert panel met and reviewed records of 672 decedents (290 pre-TS and 382 post-TS) who met standardized inclusion criteria, were judged potentially salvageable, and were selected by a proportional sampling of the roughly 2,500 annual trauma deaths. Deaths were adjudicated into sub-categories of nonpreventable and preventable causes. The value of lives lost was calculated for those lives potentially saved in the post-TS period. <br><br>RESULTS: Total preventable mortality was reduced from 30% of cases pre-TS to 16% of cases studied post-TS, a reduction of 14%. Extrapolating a 14% reduction of preventable mortality to the post-TS study period, using the same inclusion criteria of the post-TS, we calculate that 79 lives were saved in 2013 to 2014 due to the institution of a TS. Using a minimal standard estimate of $100,000 value for a life-year, a lifetime value of $2,365,000 per person was saved. This equates to an economic impact of the lives saved of almost $186 million annually, representing a 9-fold return on investment from the $20 million of annual state funding invested in the TS. <br><br>CONCLUSIONS: The implementation of a TS in Arkansas during a 5-year period resulted in a reduction of the preventable death rate to 16% post-TS, and a 9-fold return on investment by the tax payer. Additional life-saving gains can be expected with ongoing financial support and additional system performance-improvement efforts.<br><br>Copyright © 2017 American College of Surgeons. Published by Elsevier Inc. All rights reserved.<p />  <p>Language: en</p>
LA  - en
SN  - 1072-7515
UR  - http://dx.doi.org/10.1016/j.jamcollsurg.2016.12.042
ID  - ref1
ER  -