'Costs & Effectiveness of Trauma Care in the Elderly'

描述（由申请人提供）：每年有近百万长者 因急性创伤住院治疗，这些数字是 预计随着老年人口比例的增长， 他们的福尔斯，机动车碰撞和攻击的风险增加， 改善整体健康状况和流动性。创伤的结果 老年人往往是穷人，因为它是一个级联导致的初始事件， 无法行动，丧失能力和死亡虽然采用系统的方法来提供 创伤护理（将更严重的受伤者分类到指定的第三级 护理设施或创伤中心）被广泛提倡改善这些 结果，有大量证据表明，一半到三分之二的人 患有严重创伤的老年人目前没有在创伤中心接受治疗。 中心，这一比例远远高于年轻患者。现有数据， 然而，这并不能让我们确定创伤后的结果是否确实更好， 中心和非创伤中心。可供比较的数据甚至更少 在创伤中心和非创伤中心医院接受护理的费用。 这项研究的目的有三：（1）估计成本 与老年创伤的急性护理和急性期后护理相关 病人，并比较这些费用的病人在创伤中心治疗， 非创伤中心;（2）检查现有医疗服务的贡献 老年人创伤后的成本和结果的条件，并检查 创伤中心/非创伤中心的老年人之间的差异， （3）描述成本和结果之间的关系， 在创伤中心和非创伤中心接受的护理，并检查 这些关系对政策和方案倡议的影响。的 这项研究利用了一项现有的努力， 在创伤中心治疗的3,000多名老年创伤患者的结果， 非创伤中心目前的要求是资助对医疗保险的分析 索赔数据。这种分析将大大提高我们估计 与损伤相关的急性和急性后护理费用，以及 提供更好的受伤前发病率信息， 对结果和成本都有很大影响。

DESCRIPTION (provided by applicant): Each year, nearly one million elders are hospitalized for treatment of an acute traumatic injury, and these figures are expected to increase as the proportion of the population that is older grows and their risk of falls, motor vehicle crashes and assaults increases due to improved overall health status and mobility. The outcome from trauma in the elderly is often poor as it serves as the incipient event in a cascade leading to immobility, incapacity and death. While a systems approach to the delivery of trauma care (with triage of the more acutely injured to designated tertiary care facilities or trauma centers) is widely advocated for improving these outcomes, there is substantial evidence to suggest that one half to two thirds of older adults with major trauma are not currently being treated at trauma centers, a far higher proportion than in younger patients. Available data, however, do not allow us to determine if outcomes are indeed better in trauma centers versus non-trauma centers. Even fewer data are available for comparing the costs of care received in trauma centers and non-trauma center hospitals. The aims of the proposed study are three-fold: (1) to estimate the costs associated with the acute care and post-acute care of the elderly trauma patient and to compare these costs for patients treated at trauma centers and non-trauma centers; (2) to examine the contribution of pre-existing medical conditions on costs and outcomes following trauma in the elderly and to examine trauma center/non-trauma center differences among the elderly with pre-existing conditions; and (3) to describe the relationship between costs and outcomes of care received in trauma centers and non-trauma centers and examine the implications of these relationships for policy and program initiatives. The study takes advantage of an existing effort that is collecting one-year outcomes on over 3,000 elderly trauma patients treated at trauma centers and non-trauma centers. The current request is for funding an analysis of Medicare claims data. This analysis would substantially improve our ability to estimate costs of both acute and post-acute care related to the injury as well as provide better information on pre-injury morbidity which is known to substantially affect both outcomes and cost.