FUTURE-SHOCK - TRAUMA IN THE MANAGED CARE ERA

This study examines the effects of managed care on the treatment of 17 24 trauma patients seen over a 2-year period at an urban Level I traum a center. Fifty-one per cent of all trauma patients were insured. Mana ged care plans represented 42 per cent of the insurance coverage overa ll, increasing from 39 per cent in the first year to 45 per cent in th e second. All treatment was provided by the receiving general surgery trauma team and was rendered independent of insurance status. Eighty p er cent of patients completed their hospitalization at the trauma cent er. Clinical outcome, transfer rates, and mortality were similar regar dless of insurance type. We conclude that managed care plans represent a significant and increasing portion of the insurance coverage of tra uma patients, and propose that national guidelines should be developed to guarantee quality and continuity of trauma care.