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MA/PhD Theses Abstracts of Current Students & Alumni |
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Scott, Linda M. 1994 - Trauma Legislation: A Medical Anthropology Perspective:
Abstract: Trauma is the leading cause of death for those forty-four years and under. It is not an "accident" - it is a preventable disease. It is a costly disease, and care runs $132.2 billion annually. What is not considered in trauma policy formation are the political pressures and social values that affect the allotment of limited funding resources. Profit margins and cost containment vie with trauma care resources for funding that result in negative cash balances, diminished staff commitment and over the past five years, closure of many trauma centers nationwide. Key stakeholders have been identified, along with their role as influential decision-makers for policies relating to health care, particularly with regard to trauma issue. The Self-Interest Paradigm was used within a medical anthropology framework to explain the influences of the policy makers on trauma care issues How they perceive their constituency evaluating their action, reactions and impact of funding is shown to be a particularly important part of the decision-making precess for health care reform and policy. Twenty four hours of observation, and interviews at a trauma center revealed findings and concerns about understanding of trauma systems and participants roles. Key stakeholders provided answers to what they felt were the influences and implications of trauma policy. Bureaucratic inconsistencies and mixed priorities with regard to trauma policy were identified. Five million dollars have been appropriated for nationwide trauma funding. This is grossly inadequate to meet the annual payout of $132.2 million, much of which is unrecoverable. The disparities between the practitioners and the policy makers is illustrated in the manner in which they talk past each other in matters concerning trauma policy. For the policy makers, trauma care is considered an option, not a necessity because of the age and income of a majority of the trauma patients. Political considerations of favorable constituency regard has had a negative impact on funding issues related to trauma. This research addresses the ramifications of trauma policy on the trauma care system in the United States.
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