trauma centers

Trend: Moving stroke victims to best, not closest hospital

Anne Zieger — Tue, 12 Aug 2008 14:05:32 -0400

Increasingly, paramedics are bypassing closer hospitals and taking potential stroke victims to the closest hospital with specialized expertise in stroke management. This approach is also becoming more common when it comes to patients with heart attacks, who are being shuttled, in some big cities, to hospitals with special cardiac teams. Making this kind of trip is already common when treating severely injured victims of accidents or violence, who are typically taken to hospitals with trauma centers rather than the closest facility at hand, and advocates of routing patients to cardiac or stroke specialty centers say patients get similar benefits. The idea is that in each of these cases, specialist staffs can move more quickly and perform better, making up for any time lost on the road.

At present, there's some debate as to whether this approach is necessary. Some specialists suggest that only a small fraction of patients with strokes, for example, can benefit from the highly specialized expertise of a stroke center, and might have done just as well at a smaller community hospital. Meanwhile, others point to research like the 2006 study in the journal Neurology, which found that when New York paramedics take patients to stroke centers, the staff delivered care faster than at hospitals not designated as stroke centers. Other studies have shown that stroke centers treating more than 100 cases a year had fewer adverse events.

To learn more about this trend:
- read this USA Today piece

Related Articles:
Program aims to coordinate heart attack care with emergency services
Hospital uses remote neurologists to treat strokes

Georgia trauma care centers in crisis

Fri, 27 Jun 2008 06:59:56 -0400

In some parts of Georgia, it could take an injured person as long as 90 minutes to reach a trauma center. Even when patients arrive, they may not get adequate care because many of the trauma centers in the state are using outdated equipment. Many centers are losing money, but providers and state officials seeking more funding to upgrade facilities say they aren't getting the support they need. The state's trauma commission has approved funding for a study to help make a stronger case with legislators to secure the resources necessary to improve care. Later this year, the American College of Surgeons will conduct a statewide assessment of trauma facilities and services. The plan is to use the results of the study to urge legislators to fund new trauma centers around the state, increasing emergency response services and expanding helicopter transportation to trauma centers.

For more info:
- see the Atlanta Constitution story

Uninsured violence victims costly for Philadelphia hospitals

Abby Christopher — Wed, 25 Jun 2008 11:54:42 -0400

Nearly 1,000 gunshot victims were treated in Philadelphia's hospitals in 2006. A large percentage of these patients were uninsured. Roughly a third relied on public health services such as Medicaid to get treatment. Such medical assistance programs reimburse hospitals about 85 percent for the cost of care, but hospitals have to absorb that rest of the bill. According to data released by the Delaware Valley Healthcare Council of the Hospital and Health System Association of Pennsylvania, Philadelphia's five Level 1 adult and pediatric trauma centers in the Philadelphia area collectively lose an estimated $8 million annually in caring for victims of violence.

As more of these victims seek treatment at the city's hospitals, it becomes harder for the medical facilities to stay solvent. A number of area hospitals can't keep up with the financial demands of treating patients with inadequate health insurance coverage. Many are losing a lot of money every year to violent crime.

With all this, Philadelphia has inadvertently become a military training hub. Doctors about to serve on medial teams in Iraq and Afghanistan visit Philadelphia's hospitals to learn how to best treat soldiers with violent injuries. Philadelphia doctors treated 786 gunshot wounds in 2004, 883 in 2005 and 987 in 2006.

For more information:
- read the full Philadelphia Inquirer story