Trauma Services Research, Cost Burden and Health Outcomes
Recent research examined temporal trends in paediatric trauma outcomes and identified factors influencing survival in New South Wales (NSW), Australia. A retrospective review of trauma data from the NSW Trauma Registry during 2003-2008 of children aged 15 years and younger who were severely injured (ISS>15) was conducted. The study included 1,138 severely injured children and found that children who received definitive treatment (i.e. majority of patient treatment and care) at a paediatric trauma centre were between 3 to 6 times more likely have a survival advantage than if they had received definitive care at an adult trauma centre.
There has been anecdotal evidence that Australia’s episode-based funding model for hospital treatment results in underfunding of trauma treatment in NSW. Paediatric trauma data for children aged ≤15 years admitted to trauma centres during 2008-09 was linked to hospital financial data and then the actual costs from each hospital were compared to Australian Refined Diagnostic Related Groups (AR-DRG) state wide peer-group average costs. There were 3,493 paediatric patients with a total cost of $20.2 million. Falls ($6.7 million) and road trauma ($4.4 million) had the highest total expenditure. The total costs incurred by trauma centres were $1.4million above the NSW peer-group average cost estimates. Paediatric trauma hospitals tasked with providing trauma care should be appropriately funded and it was suggested that future funding models should consider trauma severity.
This research was awarded ‘Best research oral presentation’ at the Australasian Injury Prevention Conference in Perth in 2013.
- Curtis K. Lam. M. Mitchell R. Dickson C. McDonnell K. (in-press, accepted 18 Sept 2013) Major trauma: The unseen financial burden to trauma centres, a descriptive multi-centre analysis. Australian Health Review
- Curtis K. Chan D. Lam M. Mitchell R. King K. Leonard L. D’Amours S. Black D. (in press, accepted 2 April 2013) The injury profile and cost of major trauma in older people in New South Wales. Australasian Journal on Ageing
- Curtis K. Lam M. Mitchell R. Black D. Taylor C. Dickson C. Jan S. Langcake M. Myburgh J. (in press, accepted 2 Oct 2012) Acute costs and predictors of higher treatment costs of trauma in New South Wales, Australia. Injury
- Mitchell R. Curtis K. Holland A. Balogh Z. Evans J. Wilson K. (2013) Acute costs and predictors of higher treatment costs for major paediatric trauma in New South Wales, Australia. Journal of Paediatrics and Child Health 49 (7), 557-563.
- Mitchell R. Curtis K. Chong S. Holland A. Soundappan SVS. Wilson K. Cass D. (2013). Comparative analysis of trends in paediatric trauma outcomes in New South Wales, Australia. Injury 44, 97-103.
- Curtis K. Mitchell R. Chong S. Balogh Z. Reed A. Clark P. D’Amours S. Black D. Langcake, M. Taylor C. McDougall P. Cameron P (2012). Injury trends and mortality in adult patients with major trauma in NSW. Medical Journal of Australia 197 (4), 233-237.
- Mitchell R. Watson W. Curtis K. Harris I. McDougall T (2012). Difficulties in establishing long-term trauma outcomes data collections – a case study: could trauma outcomes be routinely monitored in New South Wales, Australia? Injury 43 (1), 96-102.
- Curtis K. Chong S. Mitchell R. Newcombe M. Black D. Langcake M. (2011). Outcomes of severely injured adult trauma patients in an Australian health service. Does trauma centre level make a difference? World Journal of Surgery 35 (10), 2332-2340.