title: Pediatric trauma care: a profitable enterprise?
abstract: OBJECTIVE
  We set out to examine whether pediatric trauma care resulted in a financial burden.
  
  
  METHODS
  We reviewed financial data for children with an International Classification of Diseases, Ninth Edition, injury diagnosis code over 2 years at an urban level I pediatric trauma center. We divided inpatients into length of stay categories, and profit or loss was calculated for each payor/length of stay category. These figures were then used to estimate revenue for each hospital based upon their patients payor/length of stay distribution that was obtained from the KID database. Our payor-based outpatient revenue figures were also applied to the other hospital-calculated outpatient visits to obtain an estimate of their outpatient revenues.
  
  
  RESULTS
  We treated 49,437 injured children with a revenue balance of more than $8 million. Commercial insurance resulted in a positive revenue stream. Losses increased as length of stay increased for patients with Medicaid or self-pay. Outpatient encounters resulted in 59% of the revenue. Extrapolating our data, 84% of pediatric trauma centers in 27 states generate an average of $800,000 revenue.
  
  
  CONCLUSIONS
  Pediatric trauma care is a profitable enterprise. Inadequate reimbursement remains for Medicaid and self-pay patients, which could result in financial losses should this proportion of the patient mix be more than 55%.
authors.affiliation: Department of Surgery, Children's Hospital Boston and Harvard Medical School, Boston, MA 02115, USA.
authors.forename: Jordan R
authors.initials: JR
authors.lastname: Gutweiler
authors.forename: David P
authors.initials: DP
authors.lastname: Mooney
mesh_terms: D000293:Adolescent; D000553:Ambulatory Care / Q000191:economics; D001900:Boston; D002648:Child; D002675:Child, Preschool; D004636:Emergency Service, Hospital / Q000191:economics; D005382:Financing, Personal / Q000191:economics / Q000706:statistics & numerical data; D006760:Hospitalization / Q000191:economics; D006776:Hospitals, Pediatric / Q000191:economics* / Q000706:statistics & numerical data; D006786:Hospitals, Urban / Q000191:economics* / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D007348:Insurance, Health / Q000191:economics / Q000706:statistics & numerical data; D007349:Insurance, Health, Reimbursement / Q000191:economics / Q000706:statistics & numerical data; D007902:Length of Stay / Q000191:economics; D008484:Medicaid / Q000191:economics / Q000706:statistics & numerical data; D014193:Trauma Centers / Q000191:economics* / Q000706:statistics & numerical data; D014947:Wounds and Injuries / Q000191:economics* / Q000628:therapy