Is state trauma funding associated with mortality among injured hospitalized patients?

Alexandria Byskosh; Meilynn Shi; Irene Helenowski; Jane L Holl; Renee Y Hsia; Amy E Liepert; Robert C Mackersie; Anne M Stey

doi:10.1016/j.amjsurg.2023.12.011

Is state trauma funding associated with mortality among injured hospitalized patients?

Am J Surg. 2024 Mar:229:133-139. doi: 10.1016/j.amjsurg.2023.12.011. Epub 2023 Dec 17.

Authors

Alexandria Byskosh¹, Meilynn Shi², Irene Helenowski³, Jane L Holl⁴, Renee Y Hsia⁵, Amy E Liepert⁶, Robert C Mackersie⁷, Anne M Stey⁸

Affiliations

¹ Department of Surgery, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA. Electronic address: Alexandria.Byskosh@gmail.com.
² Department of Surgery, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA. Electronic address: Meilynn.Shi@northwestern.edu.
³ Department of Surgery, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA. Electronic address: I-helenowski@northwestern.edu.
⁴ Department of Neurology, Center for Healthcare Delivery Science and Innovation, University of Chicago, Chicago, IL, USA. Electronic address: jholl@neurology.bsd.uchicago.edu.
⁵ Department of Emergency Medicine, School of Medicine, University of California San Francisco, San Francisco, CA, USA; Philip R. Lee Institute for Health Policy Studies, University of California San Francisco, San Francisco, CA, USA. Electronic address: Renee.Hsia@ucsf.edu.
⁶ Department of Surgery, School of Medicine, Marquette University, Columbia, MO, USA. Electronic address: Aliepert@health.missouri.edu.
⁷ Department of Surgery, School of Medicine, University of California San Francisco, San Francisco, CA, USA. Electronic address: Robert.Mackersie@ucsf.edu.
⁸ Department of Surgery, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA. Electronic address: anne.stey@nm.org.

PMID: 38155075
PMCID: PMC10998441 (available on 2025-03-01)
DOI: 10.1016/j.amjsurg.2023.12.011

Abstract

Background: We sought to quantify the association between state trauma funding and (1) in-hospital mortality and (2) transfers of injured patients.

Methods: We conducted an observational cross-sectional study of states with publicly available trauma funding data. We analyzed in-hospital mortality using linked data from the Nationwide Inpatient Sample (NIS), American Hospital Association (AHA) Annual Survey, and these State Department of Public Health trauma funding data.

Results: A total of 594,797 injured adult patients were admitted to acute care hospitals in 17 states. Patients in states with >$1.00 per capita state trauma funding had 0.82 (95 % CI: 0.78-0.85, p < 0.001) decreased adjusted odds of in-hospital mortality compared to patients in states with less than $1.00 per capita state trauma funding.

Conclusions: Increased state trauma funding is associated with decreased adjusted in-hospital mortality.

Keywords: Acute care; Mortality; Trauma; Trauma funding.

Publication types

Observational Study

MeSH terms

Adult
Cross-Sectional Studies
Hospital Mortality
Hospitalization
Humans
Retrospective Studies
Trauma Centers*
United States / epidemiology
Wounds and Injuries* / therapy

Grants and funding

K23 HL157832/HL/NHLBI NIH HHS/United States