ArticleThe journal of trauma and acute care surgery2019
The economic footprint of acute care surgery in the United States: Implications for systems development.
Article in The journal of trauma and acute care surgery, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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Who cites it
12 citing papers in PubMed.
- The current state of acute care surgery workforce and practice models: A joint statement by the American Association for the Surgery of Trauma, the American College of Surgeons Committee on Trauma, the Eastern Association for the Surgery of Trauma, and the Western Trauma Association.The journal of trauma and acute care surgery · 2026Article
- Building an emergency general surgery registry to track and benchmark outcomes.Trauma surgery & acute care open · 2026Article
- Inpatient Trauma Care Costs in the US From 2012 to 2021.JAMA network open · 2025Article
- Health Equity and Emergency Colorectal Surgery in the United States: A Scoping Review.The Journal of surgical research · 2025Article
- Beyond capacity: an EAST multicenter mixed-methods study exploring surgeon perceptions on patient ratios in acute care surgery.Trauma surgery & acute care open · 2025Article
- Application of Community Detection Methods to Identify Emergency General Surgery-Specific Regional Networks.JAMA network open · 2024Article
- The importance and benefits of defining full-time equivalence in the field of acute care surgery.Trauma surgery & acute care open · 2024Article
- Cesena guidelines: WSES consensus statement on laparoscopic-first approach to general surgery emergencies and abdominal trauma.World journal of emergency surgery : WJES · 2023Article
- Variability in hospital costs for short stay emergent laparoscopic appendectomy.Surgery open science · 2022Article
- Data resources for evaluating the economic and financial consequences of surgical care in the United States.The journal of trauma and acute care surgery · 2022Review
- Impact of the Affordable Care Act Medicaid Expansion on Reimbursement in Emergency General Surgery.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2022Article
- Emergency general surgeons: the special forces of general surgery (the "navy seals paradigm").World journal of emergency surgery : WJES · 2020Article
Corrections and comments
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Authors and funding
10 authors.
Funding
Abstract
backgroundAcute care surgery (ACS) comprises trauma, surgical critical care, and emergency general surgery (EGS), encompassing both operative and nonoperative conditions. While the burden of EGS and trauma has been separately considered, the global footprint of ACS has not been fully characterized. We sought to characterize the costs and scope of influence of ACS-related conditions. We hypothesized that ACS patients comprise a substantial portion of the US inpatient population. We further hypothesized that ACS patients differ from other surgical and non-surgical patients across patient characteristics.
methodsWe queried the National Inpatient Sample 2014, a nationally representative database for inpatient hospitalizations. To capture all adult ACS patients, we included adult admissions with any International Classification of Diseases-9th Rev.-Clinical Modification diagnosis of trauma or an International Classification of Diseases-9th Rev.-Clinical Modification diagnosis for one of the 16 AAST-defined EGS conditions. Weighted patient data were presented to provide national estimates.
resultsOf the 29.2 million adult patients admitted to US hospitals, approximately 5.9 million (20%) patients had an ACS diagnosis. ACS patients accounted for US $85.8 billion, or 25% of total US inpatient costs (US $341 billion). When comparing ACS to non-ACS inpatient populations, ACS patients had higher rates of health care utilization with longer lengths of stay (5.9 days vs. 4.5 days, p < 0.001), and higher mean costs (US $14,466 vs. US $10,951, p < 0.001. Of all inpatients undergoing an operative procedure, 27% were patients with an ACS diagnosis. Overall, 3,186 (70%) of US hospitals cared for both trauma and EGS patients.
conclusionAcute care surgery patients comprise 20% of the inpatient population, but 25% of total inpatient costs in the United States. In addition to being costly, they overall have higher health care utilization and worse outcomes. This suggests that there is an opportunity to improve clinical trajectory for ACS patients that in turn, can affect the overall US health care costs. LEVEL OF EVIDENCE: Epidemiologic, level III.
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