Hospitals Are Cutting Costs By Not Treating Gunshot Victims Right Away

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For companies facing a crisis, it’s best to focus on the outcome rather than the money.

This is especially true with hospitals, which encounter crises every day.

However, a look at 25,000 cases of shooting and stabbing injuries in the abdomen between 2002 and 2008 from the National Trauma Data Bank found that more hospitals are opting for no-surgery options when possible, reports NPR.

Typically, surgeons will open up a patient to look for internal damage — called explorative surgery — but that’s changing.

The study found that approximately 22% of gunshot-wound and 34% of stab-wound patients were treated without immediate surgery. Instead, they underwent diagnostic testing and were put on careful surveillance.

This is the more cost-effective option. When it’s successful, the payoffs are big — the average hospital stay for selective nonoperative management (SNOM) is four to six days compared to 13 for patients who underwent exploratory surgery. For patients who initially underwent SNOM and later needed surgery, hospital stays were between eight to 14.

But researchers say that choosing the wrong patients for the non-operative option “substantially increases their risk of death from these injuries” they were 4.5 times more likely to die than those who received immediate care. It’s unclear whether those patients would’ve died if they received exploratory surgery.

“If it fails, it’s a big price to pay,” Adil Haider, senior author of the research, told NPR. “The consequences are dire.”

On the other hand, “managing gunshot and stab wounds without exploratory surgery prevents complications, saves money and keeps 80% of patients from getting operations that end up being unnecessary,” Haider told The JHU Gazette. “But not every hospital should pursue this course because if physicians make a mistake, the patient pays. It’s not a slam-dunk decision.”

Hospitals are unlike many institutions in that they deal with risk-intensive situations every day. But there are lessons to be learned for any small business: unless you have highly-trained and skillful experts, carefully consider the consequences and chances you take in high-risk situations.