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Cost of Over-Triage on Our Nation’s Health
System
Newswise, September 2010 — Researchers at
the University of California, San Diego
School of Medicine have identified
“secondary over-triage” as a potential area
of cost savings for our nation’s health
care. The phenomenon of over-triage occurs
when patients are transferred twice, and
discharged from a second facility in less
than 24 hours.
These findings were published in the
September 10th issue of The
Journal of Trauma.
“By looking at the number of times patients
are transferred, we can evaluate the overall
efficiency of our trauma system and its
impact on healthcare costs,” said Hayley
Osen, research analyst for the UCSD Center
for Surgical Systems and Public Health. “The
average cost of a patient who faces
secondary over-triage is $5,917, a
significant burden given that per capita
spending alone in the U.S. is around
$8,000.”
“Primary over-triage” refers to the
transport of patients from the field to
hospitals while “secondary over-triage”
refers to the transport of patients between
hospitals, involving the decision making of
hospital-based medical personnel.
“The paper highlights the issue of defensive
medicine,” said David Chang, PhD, MPH, MBA,
director of the UCSD Center for Surgical
Systems and Public Health. “We found that
pediatric patients are most prone to
secondary over-triage, which may be due to
physicians or hospitals being overly
cautious for fear of legal repercussions.”
The paper indicates that 20 percent of
pediatric patients were discharged within 24
hrs after transfer to a second facility.
Rapid discharge after transfer was defined
as patients who were discharged within one
day and did not receive any surgical
procedure. Chang noted that if patients are
discharged within 24 hrs, it is unlikely
they needed to be transferred in the first
place.
Part of the Department of Surgery, the UCSD
Center for Surgical Systems and Public
Health is an outcomes-based research program
dedicated to improving the nation’s
healthcare systems by shaping science
research, public policy and clinical
practice.
Researchers for this paper included Hayley
B. Osen, BA, Robert R. Bass, MD, Fizan
Abdullah, MD, and David C. Chang, PhD, MPH,
MBA.
