Financial aspects of providing trauma care at the extremes of life

J Trauma. 1999 Mar;46(3):483-7. doi: 10.1097/00005373-199903000-00025.

Abstract

Background: Children and the elderly are more likely to be underinsured compared with the general population of trauma patients. We performed financial analysis on all trauma patients admitted during an 18-month period to a Level I adult and pediatric trauma center to evaluate the financial impact of providing trauma care for children and the elderly.

Methods: Patients were categorized by age: PEDI<17 years, GERI>64 years and MID = 17 to 64 years. Reimbursement ratio (RR = reimbursement/cost; RR>1 = profit, RR<1 = loss), length of stay (LOS), and Injury Severity Score (ISS) were calculated for each age group.

Results: RR for GERI (RR = 0.99) was significantly lower than for PEDI (RR = 1.15) and MID (RR = 1.16). There was no difference in ISS, but the LOS of GERI was greater than that of PEDI and MID (p<0.05). Cost per patient and LOS were less in PEDI versus MID and GERI (p<0.05).

Conclusion: Trauma care reimbursement for the elderly is inadequate, whereas pediatric trauma care costs less to deliver and is profitable to the trauma center.

MeSH terms

  • Accounting / methods
  • Adolescent
  • Age Factors
  • Aged
  • Child
  • Child, Preschool
  • Diagnosis-Related Groups / economics
  • Health Services Research
  • Hospital Costs / statistics & numerical data*
  • Humans
  • Infant
  • Infant, Newborn
  • Injury Severity Score
  • Length of Stay / economics
  • Length of Stay / statistics & numerical data
  • Reimbursement Mechanisms / economics
  • Retrospective Studies
  • Trauma Centers / economics*
  • Trauma Centers / statistics & numerical data
  • Vermont
  • Wounds and Injuries / economics*
  • Wounds and Injuries / therapy