title: Trauma center downstream revenue: the impact of incremental patients within a health system.
abstract: BACKGROUND
  The purpose of this study is to assess the downstream clinical and financial impact of a trauma, burn, and emergency surgery service at an academic Level I trauma center.
  
  
  METHODS
  All patients admitted to the trauma, burn, and emergency surgery service from fiscal years 2002 to 2004 were identified. Clinical and financial data including inpatient and outpatient activity were analyzed for 365 days (downstream) after initial service admission. Data were divided into total service, trauma and burn, inpatient, outpatient, hospital, and professional revenue.
  
  
  RESULTS
  In all, 3,679 patients were admitted during the study period with total initial revenue approaching $103 million. Of these, 1,566 patients were subsequently admitted for downstream inpatient activity, resulting in almost $26 million in subsequent inpatient revenue. The initial patient admissions resulted in over 17,000 clinic visits during the course of the 3 study years. Professional revenue resulted in over $14 million for the initial admission and $6.1 million in downstream revenue during the study period.
  
  
  CONCLUSIONS
  Trauma, burn, and emergency surgical services result in both substantial initial and downstream revenue for the hospital (inpatient and outpatient) and professional components. Services committed to caring for the injured and emergent patients substantially contribute to the institutional financial strength.
authors.affiliation: Department of Surgery, University of Michigan Health System, MI 48109-0033, USA. taheri@umich.edu
authors.forename: Paul A
authors.initials: PA
authors.lastname: Taheri
authors.forename: Paul M
authors.initials: PM
authors.lastname: Maggio
authors.forename: Joseph
authors.initials: J
authors.lastname: Dougherty
authors.forename: Christopher
authors.initials: C
authors.lastname: Neil
authors.forename: Steven
authors.initials: S
authors.lastname: Fetyko
authors.forename: Deborah R
authors.initials: DR
authors.lastname: Harkins
authors.forename: David A
authors.initials: DA
authors.lastname: Butz
mesh_terms: D000046:Academic Medical Centers / Q000191:economics*; D000553:Ambulatory Care / Q000191:economics; D002053:Burn Units / Q000191:economics; D004636:Emergency Service, Hospital / Q000191:economics; D005377:Financial Management, Hospital; D008824:Michigan; D014193:Trauma Centers / Q000191:economics*