title: Identification and categorization of and cost for care of trauma patients: a study of 12 trauma centers and 43,219 statewide patients.
abstract: Medical and demographic data for trauma patients (n = 7120) admitted to 12 trauma centers in 1 year were reviewed. Data from New York State on all discharges for the same year (n = 2,535,501) were obtained and analyzed. Patients were identified as trauma patients based on NYC EMS trauma center advisory committee criteria translated into ICD-9-CM codes, and a computer-based algorithm was developed that identified 43,219 trauma patients. A standard resource cost (SRC) was also developed to compare relative cost among trauma and non-trauma patients in the same diagnosis-related groups (DRGs). The mean age of the 43,219 trauma patients was 43.1 years, 61.8% were male, the mean LOS was 13.4 days, the mean ISS was 10.4, and 61% were discharged from community hospitals. Trauma centers treated the more severely injured patients: mean ISSs were 12.3, 10.9, and 9.2 for level I, level II, and community hospitals, respectively. Payor mix varied by category, with 71% of penetrating trauma victims covered by Medicaid or self pay compared with 21% of blunt trauma victims. Level I centers treated twice as many self-pay and Medicaid patients as community hospitals. A comparison of relative cost showed that trauma patients cost 27.5 million dollars more than non-trauma patients in the same DRGs.
authors.affiliation: Department of Surgery, Cornell University Medical College, New York, NY 10021.
authors.forename: S A
authors.initials: SA
authors.lastname: Joy
authors.forename: L K
authors.initials: LK
authors.lastname: Lichtig
authors.forename: R A
authors.initials: RA
authors.lastname: Knauf
authors.forename: K
authors.initials: K
authors.lastname: Martin
authors.forename: R W
authors.initials: RW
authors.lastname: Yurt
mesh_terms: D000328:Adult; D000465:Algorithms; D017281:Cost of Illness; D003710:Demography; D003953:Diagnosis-Related Groups; D005260:Female; D006801:Humans; D015601:Injury Severity Score; D007349:Insurance, Health, Reimbursement; D007902:Length of Stay; D008297:Male; D008484:Medicaid; D008875:Middle Aged; D009518:New York; D014193:Trauma Centers / Q000191:economics; D014481:United States; D014947:Wounds and Injuries / Q000145:classification / Q000191:economics* / Q000628:therapy*