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Featured in NEJM Journal Watch: Most Severe Trauma Cases Not Transferred — Physician’s First Watch

Medical News |
March 3, 2014

Featured in NEJM Journal Watch: Most Severe Trauma Cases Not Transferred

By the NEJM Journal Watch Editors

While insurance status may have played a role in the decision to not transfer patients to trauma centers, hospital capabilities and injury patterns were likely more influential, according to a JAMA Surgery study of some 4500 adults with injury severity scores above 15, less than half of whom were transferred.

Admission rather than transfer was more likely if the initial hospital was a metropolitan teaching hospital (26% higher adjusted absolute risk of admission), the patient had severe abdominal injuries (16% higher risk), or the patient had Medicaid, Medicare, private, or other insurance (14%, 13%, 11%, and 13% higher risks, respectively). Transfers were more likely if the initial hospital was rural or the patient had severe head and neck injuries.

Reader Comments (1)

William DeMedio MD Physician, Family Medicine/General Practice

It is sad when anyone even looks at insurance status in a case of severe trauma. This should have no bearing on medical treatment whatever. Severe trauma should be treated with no need or consideration to look at the insurance; this can come later after the patient is stabilized(for transport if necessary). This article tells me very much about American medicine.

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