Rotondo says there could be any number of reasons for the price variance. "There is tremendous advantage to having hospitals near each other and lots of physicians in a region because it allows the providers to do collective bargaining in essence with suppliers. This could be strictly a difference in pricing related to implants or it could be pharmacy costs. It may not have anything to do with physician fees or practice patterns," he says.
"When we look at our supply costs in rural environments, they are much higher because of the way contracts are drawn. We have a lot more work to do to sort out and get down to answer these sorts of seminal questions and this is the kind of research that spurs on us."
Ricardo Martinez, MD, the former director of the National Highway Transportation Safety Administration, told HealthLeaders Media that trauma care has made great strides in improving survival rates, "and now we have to look at what is the most cost-effective care." He says the Hopkins study provides an excellent reason to promote evidence-based medicine.
"With all the growing data we have to look at the information coming out to see what is truly of value and what doesn't make a difference," says Martinez, an emergency physician who is now CMO with Atlanta-based North Highland consultants.
"For example, the growth of ultrasound has eliminated a lot of CT scans, but that takes years to disseminate and become adopted. Trauma care is one of the programs that has the best data so can we use that data to be more cost effective. We know it saves lives and we can use it to save money too."