Original Scientific ArticlesTrauma services: a profit center?
Section snippets
Methods
All injured patients discharged from our Level I Trauma Center in fiscal year 1997 (FY97) were included in the analysis. The trauma population was classified using the Injury Severity Score (ISS). The population was then stratified into 2 distinct groups. Patient grouping was facilitated by combining the trauma registry with the hospital cost accounting system. We chose an ISS more or less than 15 to determine major and minor traumatic injury. Group A included those patients with an ISS > 15 (n
Results
Average lengths of stay for the total population and Groups A and B were 7.5, 9.8, and 6.7 days respectively. Mortality in each group was 9.7%, 19.3%, and 6%. Mean age in the entire population was 42 years with a range of 18 to 93 years. Groups A and B were essentially identical for both mean and age range. Cost breakdown for each group is depicted in Table 1. The total cost of care for the entire population in fiscal 1997 was $15,741,862. Median, mean, and standard deviation for the total
Discussion
Despite the large body of literature that identifies treatment of critically ill patient as the most costly and least profitable,3, 4, 5, 6, 7 our data suggest otherwise. Patients in Group B (ISS ≥ 15) are responsible for 44% of the service cost while accounting for only 28% of the admissions. It is these highly injured patients that historically have been classified as the group for which the hospital is inadequately reimbursed. We have previously detailed our ability to reduce the variable
References (11)
- et al.
Financial risk and hospital cost in stratified, peripheral vascular surgical DRGs without complications and comorbidities
Ann Vasc Surg
(1989) - et al.
Effect of patient factors on hospital costs for major bowel surgeryimplications for managed health care
Surgery
(1995) - et al.
Financial implications of prolonged ventilator care under DRGs 474 and 475
Chest
(1989) - et al.
Preventable trauma deathsa review of trauma care system development
JAMA
(1985) - et al.
Diagnosis-related groups, costs, and outcome for patients in the intensive care unit
Heart Lung
(1989)
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