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The Misconception of Trauma Reimbursement
Marc J. Shapiro, MD;
Mary Keegan, RN;
Jerry Copeland, ACSW
Arch Surg. 1989;124(10):1237-1240.
Abstract
• As health care costs increase, hospital reimbursement from trauma victims is decreasing. Thus, the number of institutions dedicated to trauma care continues to decrease in this country. Two hundred eight consecutive patients admitted to a level 1 trauma center were evaluated during a 10-month period. The total bill for 207 patients was $4 044 156, averaging $19 537 per patient. Total reimbursement 6 months after billing was $2 054 090, 51% of the total bill. Methods to improve reimbursement include increasing the ratio of blunt to penetrating trauma victims and by assembling a team knowledgeable in reimbursement options. However, because a major portion of trauma reimbursement comes under federal government regulation, topics such as diagnostic related groups and other classification criteria of critically injured patients need to be reevaluated, or underpayment for trauma patients will continue to be a national plague.
(Arch Surg. 1989;124:1237-1240)
Author Affiliations
From the Department of Surgery, St Louis University Medical Center, Mo.
Footnotes
Accepted for publication August 3, 1989.
Reprint requests to the Department of Surgery, St Louis University Medical Center, 3635 Vista, PO Box 15250, St Louis, MO 63110 (Dr Shapiro).
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