title: The salutary effect of an integrated system on the rate of repeat CT scanning in transferred trauma patients: Improved costs and efficiencies.
abstract: BACKGROUND
  Duplication of Computed Tomography (CT) scanning in trauma patients has been a source of quality waste in healthcare and potential harm for patients. Integrated and regional health systems have been shown to promote opportunities for efficiencies, cost savings and increased safety.
  
  
  METHODS
  This study evaluated traumatically injured patients who required transfer to a Level One Trauma Center (TC) from either within a vertically integrated healthcare system (IN) or from an out-of-network (OON) hospital.
  
  
  RESULTS
  We found the rate of repeat CT scanning, radiology costs and total costs for day one of hospitalization to be significantly lower for trauma patients transferred from an IN hospital as compared to those patients transferred from OON hospitals.
  
  
  CONCLUSIONS
  The inefficiencies and waste often associated with transferred patients can be mitigated and strategies to do so are necessary to reduce costs in the current healthcare environment.
authors.affiliation: Department of Emergency Medicine, Intermountain Medical Center, Salt Lake City, UT, USA. Electronic address: joseph.bledsoe@imail.org.
authors.forename: Joseph
authors.initials: J
authors.lastname: Bledsoe
authors.affiliation: Department of Surgery: Trauma, Acute Care Surgery and Critical Care, University of Wisconsin Medical Center, Madison, WI, USA.
authors.forename: Amy E
authors.initials: AE
authors.lastname: Liepert
authors.affiliation: Institute for Health Care Delivery and Research, Intermountain Healthcare, Salt Lake City, UT, USA.
authors.forename: Todd L
authors.initials: TL
authors.lastname: Allen
authors.affiliation: Institute for Health Care Delivery and Research, Intermountain Healthcare, Salt Lake City, UT, USA.
authors.forename: Li
authors.initials: L
authors.lastname: Dong
authors.affiliation: Institute for Health Care Delivery and Research, Intermountain Healthcare, Salt Lake City, UT, USA.
authors.forename: Jamon
authors.initials: J
authors.lastname: Hemingway
authors.affiliation: Department of Surgery & Division of Trauma, Intermountain Medical Center, Salt Lake City, UT, USA.
authors.forename: Sarah
authors.initials: S
authors.lastname: Majercik
authors.affiliation: Department of Surgery & Division of Trauma, Intermountain Medical Center, Salt Lake City, UT, USA.
authors.forename: Scott
authors.initials: S
authors.lastname: Gardner
authors.affiliation: Department of Surgery & Division of Trauma, Intermountain Medical Center, Salt Lake City, UT, USA.
authors.forename: Mark H
authors.initials: MH
authors.lastname: Stevens
mesh_terms: D017046:Cost Savings; D019033:Delivery of Health Care, Integrated; D004526:Efficiency; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010360:Patient Transfer; D011446:Prospective Studies; D014057:Tomography, X-Ray Computed / Q000191:economics* / Q000706:statistics & numerical data*; D019564:Unnecessary Procedures / Q000191:economics* / Q000706:statistics & numerical data*; D014947:Wounds and Injuries / Q000000981:diagnostic imaging*
keywords: Computed tomography; Cost; Efficiency; Patient transfer