MOTOR-VEHICLE CRASHES AND SEAT BELTS - A STUDY OF EMERGENCY PHYSICIANPROCEDURES, CHARGES, AND DOCUMENTATION

Study objective: To study emergency physician documentation of seat be lt use, practice patterns, and charges for patients with different res traints involved in motor vehicle crashes. Design: Retrospective exami nation of 2,239 emergency department records during a 5-month period. Participants: Patients from four community EDs and one Level I trauma center ED. Results: Documentation of seat belt use for motor vehicle c rash occupants was reported in 70% of the ED records reviewed. Only 64 .5% of the records from the four community hospital EDs recorded seat belt use, compared with 81.7% of the records from the trauma center ED (P<.001). The unbelted group had a greater mean number of physician p rocedures performed (1.4 versus 1.2; P<.001) and more radiographs of t he face and skull ordered (11.9% versus 8%, P<.01). Seat belt users ha d a higher average number of cervical-spine radiographs ordered than d id nonusers (71.5 versus 65.7; P<.05). Physician charges for unbelted patients were higher compared with those for belted patients, averagin g $22.00 more per patient (P<.001). Conclusion: Emergency physician pr actice patterns reflect the distribution of injuries associated with s eat belt use and nonuse. Reduced physician charges for belted patients contributed to health care cost savings. Emergency physicians should be encouraged to consistently obtain and record whether an individual was wearing a seat belt during a motor vehicle crash.