Citation

Guagliardo MF, Jeng JC, Browning S, Bilodeau ME, Dimick A, Hickerson W, Miller S, Peck M. J. Burn Care Res. 2008; 29(1): 151-157.

Affiliation

Center for Health Services and Community Research, Children’s National Medical Center; †The Burn Center at Washington Hospital Center, Washington DC.

Copyright

(Copyright © 2008, American Burn Association, Publisher Lippincott Williams and Wilkins)

DOI

10.1097/BCR.0b013e31815fa480

PMID

18182914

Abstract

One of the most significant data collection efforts undertaken by the American Burn Association, the National Burn Repository (NBR) now encompasses more than 180,000 admissions. The Government Affairs Committee designated the prevalence of across-state-line burn admissions as one of its initial major inquiries to be made of the NBR. This line of inquiry could have bearings on healthcare access, legislative advocacy, and burn center solvency. The NBR Advisory Committee provided a specifically abstracted report after the 2005 call for data. Because of patient confidentiality concerns the file only contained admission frequencies by state-of-injury:state-of-care pairs. Nevertheless we were able to produce suggestive summary statistics and national maps for interpretations. This abstracted data encompasses records between 1995 and 2005, during which 8157 cross-state border admissions occurred, 6714 of which were to non-Shriner's hospitals. The rate of border crossing ranged from 0 to 202 patients annually. The highest rates were from the northernmost western states, northernmost New England states, and several southern states. Utah, West coast, and Great Lakes states sent relatively few admissions to other states. Twenty-seven states received no out-of-state admissions whereas several states had very high hosting rates. Although mapping cross-state burn admissions is an elementary exercise it demonstrated the value of the NBR for the Committees on Organization and Delivery, Government Affairs, and other facets of the American Burn Association. Anticipated access to ZIP Code data will permit: 1) granular identification of underserved areas, 2) documentation and prediction of reimbursement challenges, 3) mapping of de facto burn center referral markets, 4) mass disaster capacity planning, and 5) community-level burn risk factor analyses.

Language: en