Impact of a dedicated trauma service on the quality and cost of care provided to injured patients at an urban teaching hospital

Background: To determine the impact of a dedicated trauma service on cost a nd quality of care in an urban teaching hospital a before-and-after study w as designed. The kev elements of the trauma service were dedicated in-house trauma attending surgeons and residents, and continuity and integration of trauma care. Methods: Injury Severity Scores and probabilities of survival for each pati ent were calculated from the hospital International Classification of Disea ses, Ninth Revision, codes, and individual patient costs were estimated fro m charges using the Medicare Cost Report. Results: The trauma ser, ice resulted in a significant increase in the seve rity of injuries. There was a highly significant (p < 0.001) increase in th e mean probability of death (from 0.16 to 0.21). There was no change In act ual mortality, Although the mean cost of care increased by 16.6% there were small reductions in the cost of care of the most severely injured patients . Conclusions: A dedicated trauma service has a positive impact on the qualit y of care.