The misconception of trauma reimbursement.
As health care costs increase, hospital reimbursement from trauma victims is decreasing. Thus, the number of institutions dedicated to trauma care continues to decrease in this country. Two hundred eight consecutive patients admitted to a level 1 trauma center were evaluated during a 10-month period. The total bill for 207 patients was $4,044,156, averaging $19,537 per patient. Total reimbursement 6 months after billing was $2,054,090, 51% of the total bill. Methods to improve reimbursement include increasing the ratio of blunt to penetrating trauma victims and by assembling a team knowledgeable in reimbursement options. However, because a major portion of trauma reimbursement comes under federal government regulation, topics such as diagnostic related groups and other classification criteria of critically injured patients need to be reevaluated, or underpayment for trauma patients will continue to be a national plague.
Shapiro
M J
MJ
Department of Surgery, St Louis University Medical Center, Mo.
Keegan
M
M
Copeland
J
J
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006744:Hospital Bed Capacity, 100 to 299; D006801:Humans; D007349:Insurance, Health, Reimbursement / Q000706:statistics & numerical data*; D008297:Male; D008484:Medicaid / Q000706:statistics & numerical data; D008875:Middle Aged; D008923:Missouri; D012189:Retrospective Studies; D014193:Trauma Centers / Q000191:economics*; D014481:United States; D014947:Wounds and Injuries / Q000191:economics* / Q000453:epidemiology / Q000401:mortality; D014949:Wounds, Nonpenetrating / Q000191:economics / Q000453:epidemiology / Q000401:mortality; D014950:Wounds, Penetrating / Q000191:economics / Q000453:epidemiology / Q000401:mortality