PHYSICIAN RESOURCE UTILIZATION AFTER GERIATRIC TRAUMA

Objective: As health care resources become increasingly strained, the value of physician consultation has come under heightened scrutiny, Th is report reviews the value of early consultation by the physical medi cine and rehabilitation (PMR) service to an integrated trauma service for geriatric patients with multiple trauma. Methods: We retrospective ly reviewed the records of 110 geriatric trauma patients (age > 60 yea rs) with an Injury Severity Score greater than or equal to 15 to evalu ate the effects of PMR consultation, Patients in group 1 were admitted to a general surgical service, and those in group 2 were admitted to a multidisciplinary trauma service, Demographic and physiologic factor s, as well as short-term and long-term outcomes, were evaluated, and a subgroup analysis,vas performed to compare early (less than or equal to 3 days) versus late (> 3 days) consultation by PMR. Results: Althou gh there were significant differences in Glasgow Coma Scale score and length of stay, no differences were found within groups in other demog raphic, physiologic, or outcome data, Focused review of PMR interventi on based on early versus late consultation revealed no significant dif ference between the two groups, Furthermore, an after-discharge phone survey revealed no significant group differences in dependence on a ca re provider or nursing home placement, readmission to hospital, employ ment status, or current functional activity status. Conclusions: Long- term patient functional outcome and the in-house rehabilitation proces s are not affected by integration of PMR into a multidisciplinary trau ma team or early PMR consultation.