Verified Centers, Nonverified Centers, or Other Facilities: A National Analysis of Burn Patient Treatment Location

Zonies, David; Mack, Christopher D.; Kramer, Bradley; Rivara, Frederick P.; Klein, Matthew B.

doi:10.1016/j.jamcollsurg.2009.11.008

Cited by 36 publications

(28 citation statements)

References 15 publications

(19 reference statements)

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“…The only recognized mechanism for assessing and confirming the quality of care provided in a burn center is verification by the American Burn Association (ABA)(11). However, in the US, non-verified (self-designated) burn centers outnumber verified burn centers(10), and half of all patients are treated outside of burn centers altogether(12). Additionally, outside of the US, there are only 4 ABA verified burn centers(13).…”

Section: Introductionmentioning

confidence: 99%

Trends in the epidemiology of major burn injury among hospitalized patients: A population-based analysis

Mason

Nathens

Byrne

et al. 2017

J Trauma Acute Care Surg

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Background Burn-related mortality has decreased significantly over the past several decades. While often attributed in part to regionalization of burn care, this has not been evaluated at the population level. Methods We conducted a retrospective, population-based cohort study of all patients with > 20% total burned surface area (TBSA) burn injury in Ontario, Canada. Adult (>16y) patients injured between 2003–2013 were included. Deaths in the emergency department were excluded. Logistic generalized estimating equations were used to estimate risk-adjusted 30-day mortality. Mortality trends were compared at burn and non-burn centers. Results 772 patients were identified at 84 centers (2 burn, 82 non-burn). Patients were 74% (n=570) male, of median age 46 (IQR 35–60) years and median TBSA 35% (IQR 25–45). Mortality at 30 days was 19% (n=149). The proportion of patients treated at a burn center increased from 57% to 71% between 2003–2013 (p=0.07). Average risk-adjusted 30-day mortality rates decreased over time; there were significantly reduced odds of death in 2010–2013 compared to 2003–2006 (OR 0.39, 95% CI 0.25–0.61). Burn centers exhibited significantly reduced mortality from 2003–2006 to 2010–2013 (OR 0.36, 95% CI 0.34–0.38) compared to non-designated centers (OR 0.41, 95% CI 0.13–1.24). Conclusions Mortality rates have decreased over time; significant improvements have occurred at burn centers while mortality rates at non-designated centers vary widely. A high proportion of patients continue to receive care outside of burn centers. These data suggest there are further opportunities to regionalize burn care and in so doing, potentially lower burn-related mortality. Level of Evidence Level III epidemiological study

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Section: Introductionmentioning

confidence: 99%

Trends in the epidemiology of major burn injury among hospitalized patients: A population-based analysis

Mason

Nathens

Byrne

et al. 2017

J Trauma Acute Care Surg

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“…15 Patients may prefer to remain near their families, homes, and primary care doctors. 15 Patients may prefer to remain near their families, homes, and primary care doctors.…”

Section: Discussionmentioning

confidence: 99%

Tracking Non–Burn Center Care

Davis

Dearwater

Rosales

et al. 2012

Journal of Burn Care & Research

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The American Burn Association publishes a list of defined criteria for patients who require admission or transfer to a burn center. This study examines the extent to which those criteria are observed within a regional burn network. Hospital discharge data for 2008 were obtained for all hospitals within the South Florida regional burn network. Patients with International Classification of Diseases, 9th revision discharge diagnoses for burns were reviewed, and their triage destination was compared with the burn triage referral criteria to determine whether patients were inappropriately triaged. Descriptive statistics were used to analyze the data. Four hundred ninety-eight burn admissions were documented to non-burn center center hospitals, 269 (54%) of which were deemed inappropriate by burn triage referral criteria. Burn center patients had greater length of stay when compared with non-burn center patients (14 vs 7 days), but a greater percentage were discharged home for self-care (88 vs 57%). Thirty-three percent of the inappropriate admissions were in a neighboring county, whereas 27% were in the same county where the burn center is located. Inappropriate burn patient triage may be occurring to more than half of the burn patients within our regional burn network despite better functional outcomes at the burn center. This may be because of a lack of knowledge regarding triage criteria, patient insurance status, or other factors. Further studies are necessary to fully characterize the problem and implement education or incentives to encourage appropriate burn patient triage.

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“…Interestingly, verified patients trended toward having fewer comorbidities. 27 The next article addresses the question of appropriate referral to burn centers. This study reported that in North Carolina 48% of the burn patients who were admitted to nonburn centers met ABA criteria for transfer to verified burn centers.…”

Section: Epidemiologymentioning

confidence: 99%

Review of Burn Research for the Year 2010

Sen

Greenhalgh

Palmieri

2012

Journal of Burn Care & Research

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Like the previous year, 2010 was another active year for research in burn care. For this year, more than 1200 burn-related articles were published on a diverse array of topics. In this review, we focus on innovative and impactful burn injury-related research. As in the previous review, we group articles according to the following categories: critical care, infection, inhalation injury, epidemiology, psychology, wound characterization and treatment, nutrition and metabolism, pain and itch management, burn reconstruction, and rehabilitation. We have found that burn research continues to be prolific throughout the world and reflects the wide-ranging and complex care requirements of burn survivors.

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Verified Centers, Nonverified Centers, or Other Facilities: A National Analysis of Burn Patient Treatment Location

Cited by 36 publications

References 15 publications

Trends in the epidemiology of major burn injury among hospitalized patients: A population-based analysis

Trends in the epidemiology of major burn injury among hospitalized patients: A population-based analysis

Tracking Non–Burn Center Care

Review of Burn Research for the Year 2010

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