A comparison between a Canadian regional trauma unit and an American level I trauma center.
Although there has been recent comparison of the Canadian and American health care systems, the issue of trauma has received little attention. Data were collected on all adult motor vehicle crash (MVC) victims admitted to the Sunnybrook Trauma Unit (CAN), Toronto, Canada, and the R Adams Cowley Shock Trauma Center (USA), Baltimore, Maryland from July 1986 through July 1990. Similar MVC victims at CAN and USA had equivalent mortality rates with similar discharge dispositions (p = NS), but patients at USA were twice as likely to be admitted to the ICU and had longer ICU stays (p < 0.01). The hospital-based cost for an average MVC patient at CAN was significantly less than for an average patient at USA and professional charges were at least five times greater at USA. This study provides some insight into the differences in trauma care between Canada and the United States.
Boulanger
B R
BR
Department of Surgery, Sunnybrook Health Sciences Centre, Toronto, Canada.
McLellan
B A
BA
Sharkey
P W
PW
Rizoli
S
S
Mitchell
K
K
Rodriguez
A
A
D000063:Accidents, Traffic / Q000191:economics / Q000401:mortality / Q000706:statistics & numerical data*; D000293:Adolescent; D000328:Adult; D015142:Baltimore / Q000453:epidemiology; D005249:Fees and Charges / Q000706:statistics & numerical data; D005260:Female; D015600:Glasgow Coma Scale; D017048:Health Care Costs / Q000706:statistics & numerical data; D006295:Health Resources / Q000191:economics / Q000706:statistics & numerical data; D006302:Health Services Research; D017052:Hospital Mortality; D006801:Humans; D015601:Injury Severity Score; D007362:Intensive Care Units / Q000706:statistics & numerical data; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D009104:Multiple Trauma / Q000175:diagnosis / Q000191:economics / Q000453:epidemiology* / Q000209:etiology / Q000628:therapy; D009864:Ontario / Q000453:epidemiology; D017063:Outcome Assessment, Health Care; D010343:Patient Admission / Q000706:statistics & numerical data; D010351:Patient Discharge / Q000706:statistics & numerical data; D014193:Trauma Centers / Q000191:economics / Q000592:standards / Q000706:statistics & numerical data*