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Review
. 2017 Jun;10(2):258-264.
doi: 10.1007/s12178-017-9414-7.

Accessibility, accountability, affordability: healthcare policy in orthopedic trauma

Renee C Genova  1 , Rachel L Box  1 , James R Ficke  2
Affiliations
Review

Accessibility, accountability, affordability: healthcare policy in orthopedic trauma

Renee C Genova et al. Curr Rev Musculoskelet Med. 2017 Jun.

Abstract

Purpose of review: This review provides historical background on trauma care in the USA and summarizes contemporary trauma-related health policy issues. It is a primer for orthopedic surgeons who want to promote improvements in research, delivery, and cost reduction in trauma care.

Recent findings: As of 2010, funding for trauma research accounted for only 0.02% of all National Institutes of Health research funding. This is disproportionate to the societal burden of traumatic injury, which is the leading cause of death and disability among people aged 1 to 46 years in the USA. The diagnosis-related group model of hospital reimbursement penalizes level-I trauma centers, which typically treat the most severely injured patients. Treatment of traumatic injury at level-I and level-II trauma centers is associated with lower rates of major complications and death compared with treatment at non-trauma centers. Patient proximity to trauma centers has been positively correlated with survival after traumatic injury. Inadequate funding has been cited as a reason for recent closures of trauma centers. Orthopedic surgeons have a responsibility to engage in efforts to improve the quality, accessibility, and affordability of trauma care. This can be done by advocating for greater funding for trauma research; choosing the most cost-effective, patient-appropriate orthopedic implants; supporting the implementation of a national trauma system; leading high-quality research of trauma patient outcomes; and advocating for greater accessibility to level-I trauma centers for underserved populations.

Keywords: Disability; Healthcare policy; Injury burden; Orthopedic trauma; Outcome measures.

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Conflict of interest statement

Conflict of interest

The authors declare that they have no conflicts of interest.

Human and animal rights

This article does not contain any studies with human or animal subjects performed by any of the authors.

Funding statement

The authors did not receive any funding or grants in support of their research for or preparation of this work.

Figures

Fig. 1
Fig. 1
Estimates of National Institutes of Health (NIH) funding for various research, condition, and disease categories showing that trauma research is underfunded compared with other conditions on the basis of disease burden. COPD chronic obstructive pulmonary disease. (Reprinted with permission from Catherine A. Richards, PhD, MPH)
See this image and copyright information in PMC

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