Impacting Policy Change for Orthopaedic Trauma.
Author information
- 1*Vanderbilt Orthopaedic Institute Center for Health Policy, Nashville, TN; and †Department of Orthopaedics, University of Pennsylvania, Philadelphia, PA.
Abstract
SUMMARY::
Traumatic injury, which remains the leading cause of death for Americans aged 1 to 44 years, costs the United States over $400 billion because of loss of productivity and medical services each year. Yet, over the last few decades, there has been decreased funding for trauma centers. The 2010 Affordable Care Act is just the start of health care reform, and Congress will continue to create and change policies directly impacting medical care. In this article, we evaluate how orthopaedic trauma surgeons can have a lasting impact on the nation's health care policy through organizations and advocacy on the local, state, and federal levels.
J Orthop Trauma. 2014 Oct;28 Suppl 10:S23-S26.
Orthopaedic Trauma Education: How Many to Train and How to Pay for It?
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- Department of Orthopaedic Surgery, Saint Louis University School of Medicine, St. Louis, MO.
Abstract
SUMMARY::
Fellowship training has become an expected extension of residency. The OTA has led the way in orthopaedics with a carefully orchestrated process, which has evolved to meet the needs of the growing interest in postgraduate orthopaedic trauma fellowships. The OTA developed the Center for Orthopaedic Trauma Advancement in a time when industry support of fellowships was declining. With the growth in fellowship programs to meet the growth of fellowship applicants, quality control has become an issue. Given that every fellowship experience is unique and the lack of regulatory control for non-Accreditation Council for Graduate Medical Education programs, the OTA has initiated its own accreditation process. The purpose of this article is to discuss current trends in orthopaedic trauma fellowship education regarding how many fellows should be trained, how to adequately pay for this training, and how the current dilemmas in fellowship training could be avoided. These issues are vital to understand in the context of health policy issues surrounding orthopaedic trauma.
J Orthop Trauma. 2014 Oct;28 Suppl 10:S2-S4.
Orthopaedic Trauma and the Evolution of Healthcare Policy in America.
Author information
- 1Vanderbilt Orthopaedic Institute Center for Health Policy, Nashville, TN.
Abstract
SUMMARY::
Healthcare policy has changed drastically, and with the 50-year anniversary of the passage of Medicare approaching in 2015, the authors evaluate the development of the current healthcare system and its relationship to the development of modern orthopaedic trauma. With more changes in healthcare policy forthcoming, it is increasingly important for the orthopaedic traumatologist to understand how changes in policy will affect practice. Historically, the motivators for change have remained largely the same over the past 50 years. The development of diagnosis-related groups, the resource-based relative value scale, and the sustainable growth rate are 3 defining policies that were designed to control costs, but which had an unexpected effect on those caring for the trauma population. Healthcare reform has a unique effect on those systems where care is dictated by a defining event or injury. Evaluating the development of trauma systems, the authors find that legislation directed toward the trauma population has been driven by the study of patient outcomes, providing an opportunity for orthopaedic traumatologists to contribute to future changes in policy. As healthcare policy changes begin to take effect, having a thorough understanding of reform and its drivers will be increasingly important in taking an active role in advocating for the field of orthopaedic trauma and its patients.
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