Michael Schiappa DDS, Benjamin Palla DMD MD, Nicholas F. Callahan MPH DMD MD
{"title":"由口腔颌面外科医生治疗的机构间急诊科转院病人的发生率和相关费用是多少?","authors":"Michael Schiappa DDS, Benjamin Palla DMD MD, Nicholas F. Callahan MPH DMD MD","doi":"10.1016/j.oooo.2024.06.008","DOIUrl":null,"url":null,"abstract":"Interfacility emergency department transfers (IETs) for maxillofacial trauma and infections are prevalent in the United States, with significant implications for health care costs. Limited availability of oral and maxillofacial surgeons (OMS) exacerbates unnecessary transfers and associated expenses. This study aimed to determine the incidence and costs of OMS IET. A retrospective cohort study was performed for maxillofacial trauma and infection IET at the University of Illinois Health main hospital via electronic medical record query for terms “infection [or] trauma [and] transfer.” Inclusion criteria required presentation from January 1, 2022 to June 30, 2022; emergency department (ED)-ED transfer; and or consultation by OMS. Distance transferred, insurance type, location of treatment, weekend presentation, and associated costs were collected. One thousand ninety-nine records were identified, including 46 trauma IET and 122 infection IET. Costs ranged from $2,683,918.90 to $7,984,912.89, indicating ∼$1.5 billion annual expenditure across US OMS programs. Three trauma IET required urgent treatment; no infection IETs were “emergent.” Trauma IET averaged 20.7 + 17.1 miles and infection IET 22.0 + 17.4 miles for transfer distance. Among trauma IET, 28 were treated in the operating room (OR), 10 had outpatient follow-up, and 8 had ED treatment. Among infection IETs, 57 received ED treatment, 56 received OR treatment, and 9 received antibiotics/no treatment. Maxillofacial trauma and infection IET impose significant health care costs. Increased funding for OMS training may mitigate the shortage and improve patient care. Further research is needed for better triaging and reimbursement strategies.","PeriodicalId":501075,"journal":{"name":"Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2024-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"What are the incidence and costs associated with interfacility emergency department transfer patients treated by oral and maxillofacial surgeons?\",\"authors\":\"Michael Schiappa DDS, Benjamin Palla DMD MD, Nicholas F. Callahan MPH DMD MD\",\"doi\":\"10.1016/j.oooo.2024.06.008\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"Interfacility emergency department transfers (IETs) for maxillofacial trauma and infections are prevalent in the United States, with significant implications for health care costs. Limited availability of oral and maxillofacial surgeons (OMS) exacerbates unnecessary transfers and associated expenses. This study aimed to determine the incidence and costs of OMS IET. A retrospective cohort study was performed for maxillofacial trauma and infection IET at the University of Illinois Health main hospital via electronic medical record query for terms “infection [or] trauma [and] transfer.” Inclusion criteria required presentation from January 1, 2022 to June 30, 2022; emergency department (ED)-ED transfer; and or consultation by OMS. Distance transferred, insurance type, location of treatment, weekend presentation, and associated costs were collected. One thousand ninety-nine records were identified, including 46 trauma IET and 122 infection IET. Costs ranged from $2,683,918.90 to $7,984,912.89, indicating ∼$1.5 billion annual expenditure across US OMS programs. Three trauma IET required urgent treatment; no infection IETs were “emergent.” Trauma IET averaged 20.7 + 17.1 miles and infection IET 22.0 + 17.4 miles for transfer distance. Among trauma IET, 28 were treated in the operating room (OR), 10 had outpatient follow-up, and 8 had ED treatment. Among infection IETs, 57 received ED treatment, 56 received OR treatment, and 9 received antibiotics/no treatment. Maxillofacial trauma and infection IET impose significant health care costs. Increased funding for OMS training may mitigate the shortage and improve patient care. 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引用次数: 0
摘要
在美国,因颌面部创伤和感染而进行的跨机构急诊科转院(IET)非常普遍,对医疗成本产生了重大影响。口腔颌面外科医生(OMS)的有限性加剧了不必要的转院和相关费用。本研究旨在确定 OMS IET 的发生率和费用。通过电子病历查询 "感染[或]外伤[和]转院 "等术语,对伊利诺伊大学健康总院的颌面外伤和感染 IET 进行了一项回顾性队列研究。纳入标准要求在 2022 年 1 月 1 日至 2022 年 6 月 30 日期间就诊;急诊科(ED)-急诊科转院;或由 OMS 会诊。收集了转院距离、保险类型、治疗地点、周末就诊情况和相关费用。确定了 199 份记录,包括 46 份创伤 IET 和 122 份感染 IET。费用从 2,683,918.90 美元到 7,984,912.89 美元不等,表明美国 OMS 项目的年支出为 15 亿美元。有三例创伤 IET 需要紧急治疗;没有感染 IET 是 "紧急 "的。外伤 IET 的平均转运距离为 20.7 + 17.1 英里,感染 IET 的平均转运距离为 22.0 + 17.4 英里。在创伤 IET 中,28 人在手术室(OR)接受了治疗,10 人在门诊接受了后续治疗,8 人在急诊室接受了治疗。在感染 IET 中,57 人接受了急诊室治疗,56 人接受了手术室治疗,9 人接受了抗生素治疗/未接受治疗。颌面部创伤和感染 IET 带来了巨大的医疗成本。增加对 OMS 培训的资金投入可缓解资金短缺问题并改善患者护理。需要进一步研究更好的分诊和报销策略。
What are the incidence and costs associated with interfacility emergency department transfer patients treated by oral and maxillofacial surgeons?
Interfacility emergency department transfers (IETs) for maxillofacial trauma and infections are prevalent in the United States, with significant implications for health care costs. Limited availability of oral and maxillofacial surgeons (OMS) exacerbates unnecessary transfers and associated expenses. This study aimed to determine the incidence and costs of OMS IET. A retrospective cohort study was performed for maxillofacial trauma and infection IET at the University of Illinois Health main hospital via electronic medical record query for terms “infection [or] trauma [and] transfer.” Inclusion criteria required presentation from January 1, 2022 to June 30, 2022; emergency department (ED)-ED transfer; and or consultation by OMS. Distance transferred, insurance type, location of treatment, weekend presentation, and associated costs were collected. One thousand ninety-nine records were identified, including 46 trauma IET and 122 infection IET. Costs ranged from $2,683,918.90 to $7,984,912.89, indicating ∼$1.5 billion annual expenditure across US OMS programs. Three trauma IET required urgent treatment; no infection IETs were “emergent.” Trauma IET averaged 20.7 + 17.1 miles and infection IET 22.0 + 17.4 miles for transfer distance. Among trauma IET, 28 were treated in the operating room (OR), 10 had outpatient follow-up, and 8 had ED treatment. Among infection IETs, 57 received ED treatment, 56 received OR treatment, and 9 received antibiotics/no treatment. Maxillofacial trauma and infection IET impose significant health care costs. Increased funding for OMS training may mitigate the shortage and improve patient care. Further research is needed for better triaging and reimbursement strategies.