Outcomes in pediatric trauma care.
Variation in clinical practice patterns has attracted the attention of specialty organizations, payers, government health agencies, and the public. Such variation raises concerns about efficacy and cost relative to the care provided. Consequently, the establishment of national benchmarks has become an increasing priority in trauma care as well as elsewhere in the health sector. Comparing treatment of pediatric injury by hospital type or physician expertise has often created more controversy than conformity. Three key components that help define quality of care include infrastructure, process, and outcome. This report will highlight outcomes studies in pediatric trauma care, often comparing outcomes by physician and hospital expertise. We will discuss pediatric trauma mortality and outcomes in abdominal, closed head, and orthopedic injuries with an emphasis on functional outcomes. Much of the data are derived from large regional and national databases, which are increasingly available and useful in the analysis of specific aspects of our health care delivery system.
Stylianos
Steven
S
Department of Pediatric Surgery, Miami Children's Hospital, Miami, Florida 33155, USA. steven.stylianos@mch.com
Ford
Henri R
HR
D019985:Benchmarking / Q000592:standards; D001930:Brain Injuries / Q000191:economics / Q000401:mortality / Q000601:surgery; D002648:Child; D003362:Cost-Benefit Analysis; D016208:Databases, Factual; D006776:Hospitals, Pediatric / Q000191:economics / Q000592:standards; D006801:Humans; D007902:Length of Stay / Q000191:economics / Q000706:statistics & numerical data; D017063:Outcome Assessment, Health Care; D011785:Quality Assurance, Health Care / Q000191:economics / Q000592:standards; D013154:Spleen / Q000293:injuries; D014193:Trauma Centers / Q000191:economics / Q000592:standards; D014481:United States; D014947:Wounds and Injuries / Q000191:economics / Q000401:mortality / Q000601:surgery*; D014949:Wounds, Nonpenetrating / Q000191:economics / Q000401:mortality / Q000601:surgery