Center for Rural Emergency

2005-2006 FUNDED SEED PROJECTS

  1. Medicaid Data and Injury 
    • Title: A Descriptive Analysis of Injury-related Healthcare Resources and Services Utilization among Recipients in the WV Medicaid Program 
    • Project Director/Lead Investigator: Michael Smith, PhD, Department of Pharmaceutical Systems and Policy WVU School of Pharmacy 
    • Institutions: WVU School of Pharmacy, WVU ICRC, WV Bureau for Medical Services (WV Medicaid)
    • Categorization: Prevention.  
      • CDC Injury Research Agenda Priority Areas Addressed:
        • Phases of the Injury Research Framework (Figure 1 page 8)  
          • Foundational: using public health surveillance approaches to quantify the extent of an injury problem and provide a foundation for developing theory-based interventions.
    • Project Size: Seed
    • Project Status: Current (4/1/05 – 3/31/06) 
    • Research Training:  A pharmacy graduate student will assist in data analysis. 
    • Key Words: Medicaid, injury, rural, medical services utilization, low income
    • Brief Summary of Project: Injury has a major impact on the lives of Americans. With its fatalities, high treatment costs and long-term disabilities, injury has become one of the significant health and medical concerns of today. Overall, injury is the 5th leading cause of death both in the U.S. and in West Virginia, and is the leading cause of death in people below age 45. Injury research has typically involved the use of fatality or mortality data. While studies recently have looked at costs of non-fatal unintentional injuries in the home, links between external causes of injury, related clinical diagnoses, and resulting utilization of healthcare resources are yet to be researched extensively.
    • Project Aims: 
      • Describe the overall distribution of injuries among WV Medicaid population;
      • Describe the patterns and costs of medical services utilization for injuries among this population, and 3) for the three most prevalent injuries in this population, describe the distribution by demographic groups and by corresponding clinical diagnosis.  
         
  2. Hip Fractures 
    • Title: Regional Variations in Outcomes Following Hip Fracture Injury: The Effect of Hospital and Surgical Volume on Complication Rates 
    • Project Director/Lead Investigator: Mary Carter, PhD, WVU Center on Aging, Department of Community Medicine 
    • Institutions: WVU Center on Aging, WVU Center for Rural Emergency Medicine, WVU ICRC, and WVU Department of Community Medicine  
    • Categorization: Prevention
      • Healthy People 2010:
        • Objective 15.28: reduce hip fractures among older adults 
    • Project Size: Seed
    • Project Status: Current (4/1/05 – 3/31/06) 
    • Research Training:  A Center on Aging graduate student will assist in data analysis. 
    • Key Words: hip fracture, falls, disability, elderly, hospital and surgical volume
    • Brief Summary of Project: A secondary data analysis of Healthcare Cost and Utilization Project (HCUP) data from 2000 and 2001 employed with small area variation research methodology will be used to explore the extent to which regional variations in patient outcomes following non-elective hip fracture surgery reflect differences in hospital and surgical volume levels.   
    • Project Aims:
      • Describe regional patterns in complications and mortality rates following non-elective hip fracture surgery. 
      • Examine whether small area variations in complication and mortality rates are related to hospital and/or surgical volume levels.  
         
  3. Tissue Modeling for Traumatic Head Injuries 
    • Title: Human Head Response to Impact and Post-traumatic Response Using WVU’s Viscoelastic Tissue Model
    • Project Director/Lead Investigator: Victor Mucino, PhD, WVU Department of Mechanical and Aerospace Engineering 
    • Institutions: WVU Department of Mechanical and Aerospace Engineering, Department of Orthopedics Musculoskeletal Research Center, WVU ICRC, Southern Consortium of Injury Biomechanics 
    • Categorization: Biomechanics
    • Priority Areas Addressed:
      • CDC Injury Research Agenda Priority Areas Addressed:
        •  Acute Care, Disability, and Rehabilitation - Develop and evaluate injury and disability interventions using biomechanical and computer models.
    • Project Size: Seed
    • Project Status: Current (4/1/05 – 3/31/06) 
    • Research Training:  A Department of Mechanical and Aerospace Engineering graduate student will assist in data analysis. 
    • Key Words: viscoelastic, ‘head injury criteria’, post-traumatic behavior, impact injury 
    • Brief Summary of Project:  A viscoelastic constitutive model for the brain tissue and skull will be used to simulate the stress and strain wave propagation within the brain mass after a controlled impact to the skull. This model that produces accurate dynamic response of the head can be extremely useful in the assessment of protective devices such as helmets for workers, pilots, motorcycle and ATV drivers, and sports players who use helmets. 
    • Project Aims:
      • Develop a finite element model of a human head using viscoelastic characterization of brain tissue incorporating DYNA3D and/or ABAQUS. 
      • Conduct ‘benchmark’ simulations of human head under impact to establish a verifiable reference. 
      • Conduct a baseline simulation of a human head impact with a ‘protective element’ (helmet).
         
  4. Telemedicine Follow-up for Orthopedic Injuries  
    • Title: Internet Telemedicine Follow-up in Orthopedic Trauma Patients  
    • Project Director/Lead Investigator: Dina L. Jones, PhD, PT, WVU Department of Orthopedics 
    • Institutions: WVU Department of Orthopedics, WVU ICRC, Preston Memorial Hospital, Doyle Sickles, MD, Inc., Roane County Family Health Care Center, Davis Memorial Hospital. 
    • Categorization: Prevention
    • Priority Areas Addressed:
      • CDC Injury Research Agenda Priority Areas Addressed:
        • Cross-cutting priorities for Injury Research - Identify the costs and consequences of injury
        • WV Healthy People 2010
          •  Access to Quality Health Care (chapter 1) 
    • Project Size: Seed
    • Project Status: Current (4/1/05 – 3/31/06) 
    • Research Training:  A Department of Orthopedics Research Nurse will assist in recruiting patients, scheduling patient follow-up visits, obtaining radiographs, and collecting data. 
    • Key Words: telemedicine, trauma, orthopedic services, health disparities, economic benefit 
    • Brief Summary of Project: The high prevalence of unintentional injuries in WV coupled with the state’s rural geography and numerous medically underserved communities, makes it imperative for orthopedic surgeons to seek innovative ways to provide medical services to more residents in the state who have sustained trauma. The telemedicine model will help provide greater access for orthopedic follow-up patients, help reduce health disparities in the West Virginia, and perhaps establish a health care delivery model for other rural states to adopt.  
    • Project Aims:
      • Safety: Determine the incidence of complications between one month and six months after injury in Telemedicine and Control Groups; establish an estimate and confidence interval for the difference in complications between the groups. 
      • Health-related Quality of Life: Determine the mean HRQOL score over a six-month period for both groups and establish an estimate and confidence interval for the mean difference in HRQOL between the two groups. 
      • Economic Benefit: Determine the economic cost savings of providing telemedicine follow-up after injury for both patients and the provider.