Document Detail


The influence of procedure delay on resource use: a national study of patients with open tibial fracture.
MedLine Citation:
PMID:  23142940     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The purpose of this study was to (1) understand national variation in delay of emergency procedures in patients with open tibial fracture at the hospital level and (2) compare length of stay and cost in patients cared for at the best- and worst-performing hospitals for delay.
METHODS: The authors retrospectively analyzed the 2003 to 2009 Nationwide Inpatient Sample. Adult patients with open tibial fracture were included. Hospital probability of delay in performing emergency procedures beyond the day of admission was calculated. Multilevel linear regression random-effects models were created to evaluate the relationship between the treating hospital's tendency for delay (in quartiles) and the log-transformed outcomes of length of stay and cost.
RESULTS: The final sample included 7029 patients from 332 hospitals. Patients treated at hospitals in the fourth (worst) quartile for delay were estimated to have 12 percent (95 percent CI, 2 to 21 percent) higher cost compared with patients treated at hospitals in the first quartile. In addition, patients treated at hospitals in the fourth quartile had an estimated 11 percent (95 percent CI, 4 to 17 percent) longer length of stay compared with patients treated at hospitals in the first quartile.
CONCLUSIONS: Patients with open tibial fracture treated at hospitals with more timely initiation of surgical care had lower cost and shorter length of stay than patients treated at hospitals with less timely initiation of care. Policies directed toward mitigating variation in care may reduce unnecessary waste.
Authors:
Erika Davis Sears; James F Burke; Matthew M Davis; Kevin C Chung
Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Plastic and reconstructive surgery     Volume:  131     ISSN:  1529-4242     ISO Abbreviation:  Plast. Reconstr. Surg.     Publication Date:  2013 Mar 
Date Detail:
Created Date:  2013-03-01     Completed Date:  2013-04-22     Revised Date:  2013-12-09    
Medline Journal Info:
Nlm Unique ID:  1306050     Medline TA:  Plast Reconstr Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  553-63     Citation Subset:  AIM; IM    
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MeSH Terms
Descriptor/Qualifier:
Adult
Costs and Cost Analysis
Emergency Treatment / economics*,  statistics & numerical data*
Female
Fractures, Open / economics*,  surgery*
Health Resources / economics*,  utilization*
Humans
Male
Retrospective Studies
Tibial Fractures / economics*,  surgery*
Time Factors
United States
Grant Support
ID/Acronym/Agency:
K24 AR053120/AR/NIAMS NIH HHS
Comments/Corrections
Comment In:
Plast Reconstr Surg. 2013 Nov;132(5):875e-876e   [PMID:  24165650 ]
Plast Reconstr Surg. 2013 Nov;132(5):874e-875e   [PMID:  24165649 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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