COGNITIVE TRAUMA CARE IS UNDERVALUED - ADULT SPLENIC INJURY AS A PARADIGM

Nonoperative management (NOM) of adult splenic injury is evolving, Eco nomic aspects of NOM have not been examined, We hypothesize that NOM r educes hospital and professional charges, Surgeon radiologist, and hos pital charges anti reimbursements, and clinical outcome were obtained for 77 consecutive adult splenic injury patients (greater than or equa l to 15 years old) over a 3-year period, NOM succeeded in 30 of 31 pat ients, NOM was associated with lower surgeon fee ($1,148 vs $4,452; P < 0.0001), surgeon reimbursement ($587 vs $2,773; P = 0.0001), and hos pital charge ($18,982 vs $48,790; P = 0.001) relative to operative man agement, Radiologist fee ($1,776 vs $2,285) and reimbursement ($1,069 vs $1,537) were not significantly affected, No significant difference existed between surgeon (primary care provider) and radiologist reimbu rsement for NOM. ISS poorly correlated with economic variables, We con clude that cost reductions axe another potential advantage of NOM. Sur geon reimbursement for the cognitive skills involved in NOM is minimal . Future health finance policy should recognize the cognitive aspects of trauma care.