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More Trauma Care Spending Doesn't Raise Survival Rates

John Commins, for HealthLeaders Media, August 13, 2012

The most expensive care was for liver injury and the average cost of care in the Northeast was $16,213. The cost was 18% more in the South, 22% more in the Midwest and 35% more in the West. The Northeast had the lowest costs for all five injury types while the West had the highest, even after factoring differences in the consumer price index.

Michael F. Rotondo, MD, FACS, a trauma and acute care surgeon, chair of the department of surgery at the University of North Carolina in Greenville, told HealthLeaders Media he "was not surprised" by the study's findings "by virtue of the fact that the healthcare practice in the country is incredibly variable."

"All politics are local but all healthcare is local as well," says Rotondo, who is also and chair for the Committee on Trauma at the American College of Surgeons. "As someone who worked in an urban environment at the University of Pennsylvania for 10 years and now for 13 years have been in a rural environment, that is clearly the case in terms of style of practice, and that is true, but also in the economics of practice. It is very different from one region of the country to another."

While he called the study "thoughtful and provocative" Rotondo says its value is limited because it relies upon "high level administrative databases" that don't delve into the specifics of each case.

"By virtue of the methodology available to the investigators they were not able to say what is driving the expenses," he says. "The message I get out of this and exactly why the College of Surgeons supports this sort of research is that we have to focus on hard-edged comparative effectiveness where we are looking at the quality of the outcomes and the cost."

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