Improved Care Needed for Elderly in Trauma Centers

Outcome-based review identifies trauma centers that provide above-average care for the elderly

FRIDAY, Feb. 4 (HealthDay News) -- The use of an outcome-based performance review of trauma centers for elderly patients indicates there is potential to improve the quality of care, according to a study published in the January issue of the Annals of Surgery.

Barbara Haas, M.D., from the University of Toronto, and colleagues analyzed data from 87,754 adult patients with moderate to severe injuries from 132 level I and II trauma centers to produce trauma-center risk-adjusted mortality rates. Observed-to-expected mortality ratios were utilized in order to identify the centers with above- or below-average performance, among both young and elderly populations.

The researchers found that 25 percent of the patients were elderly (over age 65). After adjusting for case mix, only nine of the trauma centers were identified as above-average in terms of performance for the elderly population. Only two of those centers were also considered to be above-average in terms of performance for young patients. The consistency of center performance across age strata was very poor, and aggregate evaluations of center performance did not reliably recognize high-performing centers for the care of elderly patients.

"Given the growing proportion of trauma patients who are elderly, processes of care most relevant to this patient population may warrant special attention in the context of ongoing quality improvement programs," the authors write.

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