title: Academic consequences of a trauma system failure.
abstract: Houston is served by only two trauma centers: Hermann Hospital (University of Texas Medical School at Houston [UTMSH]), and Ben Taub General Hospital (Baylor College of Medicine). In mid-1988, Hermann Hospital, prompted by a shortage of ICU nurses and +8.0 million/yr of uncollectible trauma charges, began to divert critically ill and injured patients to the already overburdened Ben Taub General Hospital. The academic consequences to UTMSH included a severe loss of clinical experience by the surgical residents and medical students and a severe reduction in faculty-generated billing. The lost billing from the trauma service and the other clinical services approximated +8.0 million/yr. This equated to an +13.5 million decrease in the anticipated billings for the year. Alternative revenue sources were not apparent. Other centers with a heavy trauma system commitment are at risk to suffer similar unsettling academic sequelae as our trauma systems fail.
authors.affiliation: Department of Surgery, University of Texas Medical School, Houston 77030.
authors.forename: R P
authors.initials: RP
authors.lastname: Fischer
authors.forename: P E
authors.initials: PE
authors.lastname: Pepe
authors.forename: R L
authors.initials: RL
authors.lastname: Reed
authors.forename: D H
authors.initials: DH
authors.lastname: Parks
authors.forename: F D
authors.initials: FD
authors.lastname: Prentice
authors.forename: K L
authors.initials: KL
authors.lastname: Mattox
mesh_terms: D000046:Academic Medical Centers; D002983:Clinical Competence; D005249:Fees and Charges; D013502:General Surgery / Q000193:education*; D006801:Humans; D007373:Interinstitutional Relations; D012577:Schools, Medical / Q000191:economics; D013503:Surgery Department, Hospital / Q000191:economics; D013781:Texas; D014187:Transportation of Patients / Q000458:organization & administration; D014193:Trauma Centers / Q000191:economics / Q000458:organization & administration* / Q000706:statistics & numerical data; D014194:Traumatology / Q000193:education