Study finds gaps in orthopedic trauma at Houston's hospital system: 5 insights

Written by Jessica Kim Cohen | August 18, 2016 | Print  |

A recent study by Laura Medford-Davis, MD — an assistant professor in emergency medicine at the Houston-based Baylor College of Medicine — found that many orthopedic trauma patients in Houston's hospital system received duplicate tests and paperwork during their follow-up appointments.

Here are five insights:


1. There are three main channels of care when an orthopedic trauma patient presents in an ED: admission for inpatient care, discharge with follow-up care or transfer to another medical center.


2. Dr. Medford-Davis found a fourth channel: "indirect referral," in which EDs refer patients for follow-up care at another medical institution without the support of a transfer center.


3. Patients who receive "indirect referral" arrive to the second ED without medical records, leading to duplicate testing and paperwork. This situation results in additional costs and delays.


4. Dr. Medford-Davis found that one in five orthopedic trauma patients who were treated in a public hospital ED later repeated that same care at another ED. Hospitals in this study billed more than $500,000 for these duplicate ED services.


5. She also found that almost 90 percent of these "indirect referral" patients were uninsured, and they were usually referred to a safety net public county hospital.


More articles on orthopedics:
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