Evidence map›Paper›PMID 40464624›Full record

SynthesisJournal of health services research & policy2026

Cost-effectiveness of specialized trauma care: A systematic review.

Soualio Gnanou, Jason Robert Guertin, Pier-Alexandre Tardif, Blanchard Conombo, Mélanie Bérubé, Natalie Yanchar, Simon Berthelot, Janyce Gnanvi, Lynne Moore

Registry-linked trialAbstract readSystematic Review
In one paragraph

Synthesis in Journal of health services research & policy, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07530653 (Delayed Resuscitation in Hemorrhagic Shock Due to Severe Injuries of the Torso in Low-resource Facilities of Latin America.), which is not on this map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT07530653 not yet recruitingnot on this map

Delayed Resuscitation in Hemorrhagic Shock Due to Severe Injuries of the Torso in Low-resource Facilities of Latin America.

TypeobservationalSponsorHospital Departamental de VillavicencioRan2026 to 2028Enrolled716ConditionsTrauma and Emergency Care, Shock,Hemorrhagic, Intravenous Fluid TherapyArmsCrystalloid below 1000 mL., IV fluids more than 1,000 mL
3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. The silver tsunami and the elective arthroplasty crisis: How geriatric trauma overruns public surgical capacity.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2026
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Soualio GnanouPopulation Health and Optimal Health Practices Research Unit, Centre de Recherche du CHU de Québec - Université Laval, Québec City, Canada.ORCID 0009-0005-2146-2137
Jason Robert GuertinPopulation Health and Optimal Health Practices Research Unit, Centre de Recherche du CHU de Québec - Université Laval, Québec City, Canada.
Pier-Alexandre TardifPopulation Health and Optimal Health Practices Research Unit, Centre de Recherche du CHU de Québec - Université Laval, Québec City, Canada.
Blanchard ConomboPopulation Health and Optimal Health Practices Research Unit, Centre de Recherche du CHU de Québec - Université Laval, Québec City, Canada.
Mélanie BérubéPopulation Health and Optimal Health Practices Research Unit, Centre de Recherche du CHU de Québec - Université Laval, Québec City, Canada.
Natalie YancharDepartment of Surgery, University of Calgary, Calgary, Canada.
Simon BerthelotPopulation Health and Optimal Health Practices Research Unit, Centre de Recherche du CHU de Québec - Université Laval, Québec City, Canada.
Janyce GnanviPopulation Health and Optimal Health Practices Research Unit, Centre de Recherche du CHU de Québec - Université Laval, Québec City, Canada.
Lynne MoorePopulation Health and Optimal Health Practices Research Unit, Centre de Recherche du CHU de Québec - Université Laval, Québec City, Canada.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

ObjectivesSeveral meta-analyses have shown the effectiveness of specialized trauma care, but evidence on cost and cost-effectiveness remains unestablished. We aimed to systematically review evidence on the cost or cost-effectiveness of hospitals specialized in advanced trauma care compared to non or less-specialized hospitals.MethodsWe conducted a systematic review following Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. We searched PubMed, EMBASE, Cochrane Library, Web-of-Science, EconLit, and grey literature up until June 2024. Two reviewers independently assessed eligibility and extracted relevant data. Reporting quality was assessed using the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) 2022 checklist. Per Cochrane recommendations, findings were synthesized qualitatively.ResultsWe identified 4 cost-effectiveness, 3 cost-consequence, and 3 cost-analysis studies, mostly US-based retrospective cohorts. Reporting quality was rated high for 4 studies. All cost-effectiveness studies found specialized trauma centres to be more costly but more effective than non-specialized centres, with incremental cost-effectiveness ratios ranging from 655 to 46,175 Int.$2022 (2022 international dollars) per quality-adjusted life-year (QALY) gained, 43,208 to 999,912 Int.$2022 per life-saved, and 48,567 Int.$2022 per life-year gained. Among cost-consequence studies, two found specialized trauma centres to be costlier and less effective, while one found the opposite. All cost analyses indicated higher costs at specialized trauma centres.ConclusionsFull economic evaluations identified in this review suggest that specialized trauma care may be cost-effective according to a threshold of $50,000 per QALY. However, our ability to draw conclusions is hampered by the low number of studies, high heterogeneity in study populations and settings, and lack of consideration of trauma systems and of costs beyond the acute phase. Results highlight a critical gap in evidence to guide policymakers in the development of cost-efficient trauma systems.

Indexed as

Cost-Benefit AnalysisTrauma CentersWounds and InjuriesHumansQuality-Adjusted Life Yearscost-effectivenessspecialized trauma caretrauma centre

Identifiers

PMID40464624
PMCPMC12647394

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.