The Impact of a Mandated Trauma Center Alcohol Intervention on Readmission and Cost per Readmission in Arizona
*Names in bold indicate Presenter
Methods: The timing of the American College of Surgeons Committee on Trauma SBI mandate created a natural experiment in Arizona. We use comparative interrupted time-series to exploit this natural experiment, comparing individuals with and without an alcohol diagnosis before and after the mandate was implemented. Study data are census of inpatient hospital admissions from six trauma centers in the Arizona State Inpatient Database from 2007-2010.
Results: The mandate resulted in a 2.2 percentage point reduction (44%) in the probability of readmission. Total health care and readmission costs were not affected by the mandate.
Conclusion: The estimates are consistent with a differential effect of SBI: SBI reduces readmissions among those who present with a less serious alcohol-related problem. Persons with more serious alcohol problems are less likely to respond to SBI. These higher-risk individuals likely have a higher cost, which may explain the lack of change in readmission costs. Our study is a macro-level intent-to-treat analysis of SBI’s impact that corroborates the potential of SBI implied by efficacy studies in trauma centers and other settings. This study provides a framework for future research involving more states and health systems and evaluating other SBI policies.
- Hinde et al. 2015_Medical Care.pdf (145.3KB)