Pediatric trauma care: a profitable enterprise?

J Pediatr Surg. 2007 Jun;42(6):1043-5; discussion 1045-6. doi: 10.1016/j.jpedsurg.2007.01.040.

Abstract

Purpose: 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%.

MeSH terms

  • Adolescent
  • Ambulatory Care / economics
  • Boston
  • Child
  • Child, Preschool
  • Emergency Service, Hospital / economics
  • Financing, Personal / economics
  • Financing, Personal / statistics & numerical data
  • Hospitalization / economics
  • Hospitals, Pediatric / economics*
  • Hospitals, Pediatric / statistics & numerical data
  • Hospitals, Urban / economics*
  • Hospitals, Urban / statistics & numerical data
  • Humans
  • Infant
  • Insurance, Health / economics
  • Insurance, Health / statistics & numerical data
  • Insurance, Health, Reimbursement / economics
  • Insurance, Health, Reimbursement / statistics & numerical data
  • Length of Stay / economics
  • Medicaid / economics
  • Medicaid / statistics & numerical data
  • Trauma Centers / economics*
  • Trauma Centers / statistics & numerical data
  • Wounds and Injuries / economics*
  • Wounds and Injuries / therapy