Trauma Patients: You Can Get Them In, but You Can’t Get Them Out

BACKGROUND:The majority of inpatient trauma care resources are consumed by a small proportion of severely injured patients.METHODS:Hospital lengths of stay (LOS), resource consumption, and postdischarge placement were abstracted from the institutional trauma registry.RESULTS:Patients (n = 4,070) were evaluated by the trauma service during the study period. The overall mean LOS was 4.4 days, and beds were occupied on 18,005 days. Two hundred forty-four (6%) patients remained in the hospital >14 days after injury and occupied beds on 8,560 (47%) days. These patients were older, more severely injured, and required proportionately more intensive care unit and operative care. Injuries to the head, abdomen, and extremities were independently associated with longer LOS. Most patients with longer LOS were placed in long-term acute care or received home nursing care after discharge.CONCLUSIONS:Almost half of inpatient trauma bed-days are occupied by a small proportion of patients with long-term care needs.