Motor vehicle crashes and seat belts: a study of emergency physician procedures, charges, and documentation.
OBJECTIVE
To study emergency physician documentation of seat belt use, practice patterns, and charges for patients with different restraints involved in motor vehicle crashes.


METHODS
Retrospective examination of 2,239 emergency department records during a 5-month period.


METHODS
Patients from four community EDs and one Level I trauma center ED.


RESULTS
Documentation of seat belt use for motor vehicle crash occupants was reported in 70% of the ED records reviewed. Only 64.5% of the records from the four community hospital EDs recorded seat belt use, compared with 81.7% of the records from the trauma center ED (P < .001). The unbelted group had a greater mean number of physician procedures performed (1.4 versus 1.2; P < .001) and more radiographs of the face and skull ordered (11.9% versus 8%, P < .01). Seat belt users had a higher average number of cervical-spine radiographs ordered than did nonusers (71.5 versus 65.7; P < .05). Physician charges for unbelted patients were higher compared with those for belted patients, averaging $22.00 more per patient (P < .001).


CONCLUSIONS
Emergency physician practice patterns reflect the distribution of injuries associated with seat belt use and nonuse. Reduced physician charges for belted patients contributed to health care cost savings. Emergency physicians should be encouraged to consistently obtain and record whether an individual was wearing a seat belt during a motor vehicle crash.
Department of Emergency Medicine, Medical College of Wisconsin, Milwaukee.
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Hargarten
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Karlson
D000063:Accidents, Traffic / Q000191:economics / Q000706:statistics & numerical data*; D017046:Cost Savings; D004282:Documentation; D004635:Emergency Medicine / Q000191:economics / Q000458:organization & administration*; D005251:Fees, Medical; D005260:Female; D006801:Humans; D008297:Male; D008499:Medical Records; D009049:Motorcycles; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data; D012189:Retrospective Studies; D012622:Seat Belts / Q000191:economics / Q000706:statistics & numerical data*; D014947:Wounds and Injuries / Q000191:economics / Q000453:epidemiology / Q000628:therapy*