The Effectiveness of Trauma Team on Medical Resource Utilization and Quality of Care for Patients with Major Trauma
| Autor: | Shu-Ting Yen, 顏淑婷 |
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| Rok vydání: | 2014 |
| Druh dokumentu: | 學位論文 ; thesis |
| Popis: | 102 Background &; aim: In Taiwan, trauma cases mainly occurred among young males, and it cost medical resource utilization over 14.1 billion NT dollars annually. About 16,000 people expired due to trauma per day worldwide. In the US, major trauma patients accounted for 23.41% of trauma inpatients in 2010. The purpose of this study were: (1) understand the major trauma patients’ medical care status and their medical resource utilization; (2) analyze the differences of medical quality of care and medical resource utilization among major trauma patients’ clinical characteristics; and (3) explore the effectiveness of trauma team on medical quality of care and medical resource utilization among major trauma patients. Methods &; questions: This was a retrospective chart review study, using trauma registry bank and admission medical service charge date bases. T-test and Chi-square analyses were used for examining indicators of medical quality of care and medical resource utilization. The study subjects were major trauma patients admitted to a medical center in Tainan during 2009 and 2013. In order to examine the effectiveness of trauma team, the research questions were: (1) Are average length of stay (ALOS) and Intensive Care Unit (ICU) stay significant declined after the establishment of trauma team? (2) Are patients with urgent operation waiting time significant declined after the establishment of trauma team? (3) Are patients with urgent operation staying in Emergency Department (ED) significant dropped after the establishment of trauma team? and (4) Are inpatient medical resource utilizations significantly reduced after the establishment of trauma team? Results: Significant reductions for several items of medical resource utilization were identified after the establishment of trauma team. The waiting time of urgent operation for severe trauma category (ISS≧25) had a significant decline after the establishment of trauma team. Especially in the group of patients who survived to discharge, three items medical resource utilization had been reduced. The radiation treatment charge and examination charge were significantly reduced in the groups of ISS=16~24 and ISS≧25. Patients who underwent surgery had significant reductions in examination charge and total medical charge. Radiation treatment charge was significantly reduced for patients with non-urgent operation. Discussion &; suggestion: The establishment of trauma team had significant effects on the reduction of medical resource utilization for major trauma patients, but had minimal effects on the improvement of medical quality of care. The results of this study can be used as a model of evaluation study for the establishment of clinical divisions, and offer a reference for health service research of medical resource utilization and quality. It can also provide the healthcare authority to promote clinical pathway for the major trauma patients in the future. |
| Databáze: | Networked Digital Library of Theses & Dissertations |
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