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Excessive overtriage in US trauma centers overwhelming system resources, delaying patient care
Date:1/25/2008

es in the Emergency Medical and Active Labor Treatment Act (EMTALA) that no longer require community hospitals to provide emergency specialty coverage. Furthermore, because emergency specialty coverage is not funded to the same degree as routine specialty care, many physicians view emergency coverage as a threat to their practice and in turn, forego emergency room call. As a result, hospitals are facing ongoing shortage of on-call emergency room physicians and are in the difficult position of having to transfer patients with minor injuries to regional trauma centers for evaluation.

In the JACS study, researchers conducted a retrospective cohort study based on institutional trauma registry data for 9,064 patients. Of those patients, 76 percent (n=6,875) arrived directly from the accident scene and 24 percent (n=2,189) were transferred from community hospitals. Although the patients who were transferred from community hospitals were on average more severely injured than those that were not transferred, the majority of these patients (64 percent) had minor injuries; 824 (39 percent) met secondary overtriage criteria, which were defined as an Injury Severity Score of less than 10 (on a scale of 75), not requiring an operation and discharge within 48 hours of arrival at the trauma center. Although this number is less than the 54 percent of patients who arrive directly from the accident scene meeting these criteria, it represents a substantial proportion of transferred patients and accounts for 9 percent of all trauma encounters.


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Contact: Sally Garneski
pressinquiry@facs.org
312-202-5409
Weber Shandwick Worldwide
Source:Eurekalert

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