Major Differences in Trauma Care between Hospitals in Sweden: A Preliminary Report
- Resource Type
- Authors
- Karl Akke Alberts; Bo Brismar; Åke Nygren
- Source
- International Journal for Quality in Health Care. 5:13-17
- Subject
- Male
Emergency Medical Services
medicine.medical_specialty
Thoracic Injuries
Femoral shaft
Hemorrhage
Hospitals, Community
Abdominal Injuries
Medical care
Hospitals, University
Preliminary report
medicine
Craniocerebral Trauma
Humans
Road traffic
Sweden
Trauma Severity Indices
business.industry
Health Policy
Process Assessment, Health Care
Accidents, Traffic
Public Health, Environmental and Occupational Health
General Medicine
medicine.disease
University hospital
Trauma care
Small hospital
Orthopedic surgery
Emergency medicine
Wounds and Injuries
Female
Medical emergency
Emergency Service, Hospital
business
Femoral Fractures
- Language
- ISSN
- 1464-3677
1353-4505
The quality of trauma care has been studied at five different Swedish hospitals. The results suggest that improvements in the quality of medical care for patients with severe road traffic injuries can be achieved by reorganizing the highly decentralized trauma care system in Sweden. Above all there is a need for a better structure and organization of the on-call system and of the cooperation of physicians of different specialties within the hospital. The medical care of patients with severe injuries was delayed in 30% and was inappropriate in 7% of cases. Assessment of the quality showed great variation between the hospitals. The medical care was in fact not best at the university hospital but at one well-functioning small hospital. It was an effect of an on-call system at the small hospital, which guarantees rapid participation of senior staff in both general surgery and orthopaedic surgery. The greatest problems arose in early diagnosis and treatment of bleeding in abdominal injuries. This was caused by inexperience in the first on-call team in combination with late assessment by second on-call consultants. Fractures of the femoral shaft in almost half of the cases did not get definitive surgery until several days after the accident.