The Cost of Trauma

Lanzarotti, Stephen; Cook, Craig S.; Porter, John M.; Judkins, Daniel G.; Williams, Mark D.
September 2003
American Surgeon;Sep2003, Vol. 69 Issue 9, p766
Academic Journal
Trauma is a financial burden. For the 2634 trauma patients seen in 1999, the percentage of their hospital bill reimbursed and cost coverage (CC), whether that reimbursement covered their hospital costs, were analyzed. Student t tests to compare the mean percentage reimbursements (mPR) and logistic regression with CC (yes/no) as dependent variable with results as odds ratio (OR) were done. The overall mPR was 36 per cent. Among the 947 patients admitted (36%), there was no association between injury severity and mPR. For penetrating trauma, the mPR (25%) was lower than for blunt trauma (37%, P = 0.05). The assault mPR (21%) was lower than for motor vehicle crash (39%, P < 0.001). The mPR for patients transferred in (26%) was lower than for all others (37%, P < 0.001). Male sex (OR = 0.76), Hispanic ethnicity (OR = 0.46), admission (OR = 0.69), severe brain injury (OR = 0.58), abdominal injury (OR = 0.65), and extremity injury (OR = 0.69) were significant predictors for no CC. Reimbursement is better for blunt trauma. That transfers had a significantly lower mPR may represent "dumping" of patients. There is an association between anatomic regions injured and CC. No reimbursement was obtained for 26 per cent of the patients, and in 56 per cent the reimbursement did not cover costs. A change in financing for trauma is needed.


Related Articles

  • National Health Insurance, Physician Financial Incentives, and Primary Cesarean Deliveries in Taiwan. Yi-Wen Tsai; Teh-Wei Hu // American Journal of Public Health;Sep2002, Vol. 92 Issue 9, p1514 

    Objectives. Taiwan's National Health Insurance Program (NHI) was implemented on March 1, 1995. This study analyzed the influences of the Case Payment method of reimbursement for inpatient care and of physician financial incentives on a woman's choice for primary cesarean delivery. Methods....

  • DO WE NEED DRGs TO IMPROVE EFFICIENCY IN HEALTHCARE. Ferraz-Nunes, Jose // Research in Healthcare Financial Management;2001, Vol. 6 Issue 1, p37 

    Focuses on a study which discussed the possibilities of use for the Prospective Payment System based on Diagnosis Related Groups as a regulation mechanism to control costs in healthcare. Definition of economic efficiency; Selection of products for economic efficiency; Analysis on the price...

  • IG says Medicare overpaid nearly $500 million on drugs in 1996. Figura, Susannah Zak // AHA News;12/15/97, Vol. 33 Issue 48, p3 

    Discusses the findings of the report `Excessive Medicare Payments for Prescription Drugs,' conducted by US Department of Health and Human Services inspector general June Gibbs Brown. Amount of prescription drug overpayment incurred by Medicare in 1996; Recommendation of a revamp of Medicare's...

  • Medicare's Prospective Payment System: A Critical Appraisal. Coulam, Robert F.; Gaumer, Gary L. // Health Care Financing Review;1991 Supplement, Vol. 13 Issue 2, p45 

    Discusses the changes created by the implementation of the Medicare prospective payment system (PPS) for hospital payment in the hospital industry in the United States. Objectives of PPS; Summary of the effects of the PPS on hospital finances; Rates of increase in hospital finances; Trends in...

  • Prospective Payment for Medicare Hospital Capital: Implications of the Research. Cotterill, Philip // Health Care Financing Review;1991 Supplement, Vol. 13 Issue 2, p79 

    Discusses the implications of prospective payment system for Medicare hospital capital in the United States. Effects on the special characteristics of capital on the cross-section variation in hospitals' capital costs; Tradition of cost-based payment for hospitals; Variation of capital and...

  • Hospitals to see 2.3% inpatient rate hike. Hallam, Kristen // Modern Healthcare;08/07/2000, Vol. 30 Issue 33, p6 

    Reports on the increase in acute-care hospitals' Medicare inpatient payment rates in fiscal 2001 in the United States. How hospitals viewed the increase; Other changes to the inpatient prospective payment system.

  • APC Implementation Expected to Reduce Settlement Amounts.  // hfm (Healthcare Financial Management);Jul2000, Vol. 54 Issue 7, p91 

    Shows the effect of the ambulatory payment classifications on payment levels of hospitals in the United States.

  • Refinements to the diagnostic cost group (DCG) model. Ellis, Randall P. // Inquiry (00469580);Winter95/96, Vol. 32 Issue 4, p418 

    Focuses on the diagnostic cost group model, originally developed by Ash et al. that has been proposed as an alternative to the existing payment system for reimbursing Medicare health maintenance organizations, the Adjusted Average Per Capita Cost. Linear regression model; Extension of previous...

  • Hospital department cost and employment increases: 1980-92. Cromwell, Jerry; Butrica, Barbara // Health Care Financing Review;Fall95, Vol. 17 Issue 1, p147 

    Examines a hospital subscriber microcost reporting system to show trends in costs, wages, labor hours and outputs for the hospital prospective payment system (PPS) in the United States from 1980 to 1992. Growth in technologically driven cost centers; Rise in administrative costs; Estimates of...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics