Citation

Punja V, Capasso T, Stokes L, Ray K, Narveson JR, Walters RW, Fernández C, Patel ND, Ewing K, Kuncir E. Am. Surg. 2023; ePub(ePub): ePub.

Copyright

(Copyright © 2023, Southeastern Surgical Congress)

DOI

10.1177/00031348231175482

PMID

37139931

Abstract

BACKGROUND: Standardization of trauma centers improves quality of care, yet that comes with financial challenges. The decision to designate a trauma center typically focuses on access, quality of care, and the needs of the local community, but less often considers the financial viability of the trauma center. A level-1 trauma center was relocated in 2017 and this presented an opportunity to compare financial data at two separate locations in the same city.

METHODS: A retrospective review was performed on the local trauma registry and billing database in all patients aged ≥19 years on the trauma service before and after the move.

RESULTS: 3041 patients were included (pre-move: 1151; post-move: 1890). After the move, patients were older (9.5 years), and more were females (14.9%) and white (16.5%). Increases in blunt injuries (7.6%), falls (14.8%), and motor vehicle accidents (1.7%) were observed after the move. After the move, patients were less likely to be discharged home (6.5%) and more likely to go to a skilled nursing facility (3%) or inpatient rehabilitation (5.5%). Post-move more patients had Medicare (12.6%) or commercial (8.5%) insurance and charges per patient decreased by $2,833, while charges collected per patient increased by $2425. Patients were seen from a broader distribution of zip codes post-move.

DISCUSSION: Relocating a trauma center did improve financial viability for this institution. Future studies should consider the impact on the surrounding community and other trauma centers. LEVEL OF EVIDENCE: Level IV.

Language: en

Keywords

trauma center; charges; finances; relocation