PMID- 32787532
OWN - NLM
STAT- MEDLINE
DCOM- 20201019
LR  - 20201019
IS  - 1661-8157 (Print)
IS  - 1661-8157 (Linking)
VI  - 109
IP  - 13
DP  - 2020
TI  - [Care Management for Polytrauma Patients in a Level-1 Trauma Centre].
PG  - 1039-1049
LID - 10.1024/1661-8157/a003532 [doi]
AB  - Care Management for Polytrauma Patients in a Level-1 Trauma Centre Abstract. In 
      our level-1 trauma institution, polytrauma patients with an Injury Severity Score 
      of 16 or higher are facing waiting times for transfer to a rehabilitation 
      facility, causing a negative financial outcome for our institution. The purpose 
      of this study is to stimulate rapid transfer to a rehabilitation facility. In a 
      single-centre case study, care management for (poly)trauma patients was started 
      to ensure time-directed treatment for trauma patients related to 
      Diagnosis-Related Groups (DRG). In the period of 2013-2018 there was an increase 
      in trauma admissions up to 14 % (n = 16 157) with a mean length of hospital stay 
      of 6.4 days, together with a reduction in the number of trauma bed capacity from 
      50 to 42. In relation to the DRGs, regular trauma patients who were not in need 
      of a stationary rehabilitation facility stayed in line with the expected time of 
      hospital stay. But (poly)trauma patients (n = 1831) with the need of a stationary 
      stay in a rehabilitation centre were faced with waiting times before they could 
      be transferred. The average excess waiting time in relation to DRG for polytrauma 
      patients was 5.1 days. Trauma patients for a rehabilitation centre have a higher 
      Case Mix Index (CMI) compared to those who do not require inpatient 
      rehabilitation (4.22 versus 1.04, p <0.0001). With about 280 trauma patients 
      annually waiting an extra 5.1 days for transfer to a rehabilitation facility, the 
      financial burden for our department amounts to Swiss francs 885,360 without 
      reimbursement. Since no extra bed capacities in rehabilitation facilities are 
      available in our area, it may be advised to set up an early in-hospital trauma 
      rehabilitation program in a level-1 trauma centre in order to reduce financial 
      loss.
FAU - Jukema, Gerrolt N
AU  - Jukema GN
AD  - Klinik fur Traumatologie, Universitatsspital Zurich.
FAU - Farokhzad, Faraneh
AU  - Farokhzad F
AD  - Medizin Controlling, Arztliche Direktion, Universitatsspital Zurich.
FAU - Volbracht, Jork
AU  - Volbracht J
AD  - Medizin Controlling, Arztliche Direktion, Universitatsspital Zurich.
FAU - Steigmiller, Klaus
AU  - Steigmiller K
AD  - Institut fur Epidemiologie, Biostatistik und Pravention, Departement 
      Biostatistik, Universitat Zurich.
FAU - Held, Ulrike
AU  - Held U
AD  - Institut fur Epidemiologie, Biostatistik und Pravention, Departement 
      Biostatistik, Universitat Zurich.
FAU - Bretscher, Barbara
AU  - Bretscher B
AD  - Klinik fur Traumatologie, Universitatsspital Zurich.
FAU - Jucker, Felicitas
AU  - Jucker F
AD  - Klinik fur Traumatologie, Universitatsspital Zurich.
FAU - Pape, Hans-Christoph
AU  - Pape HC
AD  - Klinik fur Traumatologie, Universitatsspital Zurich.
LA  - ger
PT  - Journal Article
TT  - Care Management fur Polytrauma-Patientinnen und -Patienten in einem 
      uberregionalen Level-1- Traumazentrum.
DEP - 20200813
PL  - Switzerland
TA  - Praxis (Bern 1994)
JT  - Praxis
JID - 101468093
SB  - IM
MH  - Diagnosis-Related Groups
MH  - Hospitalization
MH  - Humans
MH  - Length of Stay
MH  - *Multiple Trauma/diagnosis/therapy
MH  - *Trauma Centers
OTO - NOTNLM
OT  - Diagnosis-Related Group
OT  - Diagnosis-Related Group (DRG)
OT  - Patient traumatise
OT  - Polytrauma-Patient/in
OT  - Rehabilitation
OT  - Trauma patient
OT  - Trauma-Patient/in
OT  - groupe lie au diagnostic
OT  - patient polytraumatise
OT  - polytrauma patient
OT  - rehabilitation
OT  - rehabilitation
EDAT- 2020/08/14 06:00
MHDA- 2020/10/21 06:00
CRDT- 2020/08/14 06:00
PHST- 2020/08/14 06:00 [pubmed]
PHST- 2020/10/21 06:00 [medline]
PHST- 2020/08/14 06:00 [entrez]
AID - 10.1024/1661-8157/a003532 [doi]
PST - ppublish
SO  - Praxis (Bern 1994). 2020;109(13):1039-1049. doi: 10.1024/1661-8157/a003532. Epub 
      2020 Aug 13.