Veenema K R
Department of Emergency Medicine, University of Rochester School of Medicine and Dentistry, NY, USA.
Acad Emerg Med. 1999 Aug;6(8):828-32. doi: 10.1111/j.1553-2712.1999.tb01216.x.
To determine whether integrating primary care sports medicine into academic emergency medicine (EM) can enhance both revenue and the academic program.
A retrospective descriptive review of all patients seen in a primary care sports medicine practice at a university hospital sports medicine clinic was done over a 24-month period. All patients seen initially in the ED for a sports injury either by the author or by another EM faculty member with follow-up by the author in the sports medicine clinic were included in the study group. The study group was analyzed for diagnoses, payor mix, and revenue generated by the ED follow-up sports medicine clinic visits.
There were 199 patients who met the inclusion criteria. This resulted in 483 ED follow-up sports medicine clinic visits. The author practiced 13 hours/week in the ED and 16 hours/week in the primary care sports medicine practice, which resulted in 1,536 sports medicine clinic hours. The study group accounted for 20% of the total patient volume in the author's primary care sports medicine practice. There were 111 lower-extremity injuries (knee 52%, foot/ankle 40%, hip/pelvis 8%), 81 upper-extremity injuries (hand/wrist 48%, shoulder 43%, elbow 9%), and seven spine injuries. Payor mix was 47% traditional indemnity, 45% HMO, 4% self-pay, and 4% Medicare/Medicaid. Total charges for the ED follow-up sports medicine clinic visits were $44,767 ($92.68/visit) and net receipts were $30,276 ($62.68/visit). This represented 20% of the total charges and 16% of the net receipts in the author's sports medicine practice during this period. Revenue generated by the ED follow-up sports medicine clinic visits could have supported 12% of the equivalent cost of the base pay for a full-time EM faculty position.
The integration of primary care sports medicine into an academic EM faculty practice can enhance revenue through the establishment of an ED follow-up sports medicine clinic while also providing an opportunity to expand resident learning experiences.
确定将基层医疗运动医学纳入学术急诊医学（EM）是否能增加收入并提升学术项目水平。
对一家大学医院运动医学诊所基层医疗运动医学实践中24个月内诊治的所有患者进行回顾性描述性分析。研究组纳入所有最初在急诊科由作者或其他急诊医学教员诊治的运动损伤患者，且作者在运动医学诊所对其进行了随访。对研究组进行分析，以确定急诊科随访运动医学诊所就诊的诊断情况、付费方构成及产生的收入。
有199名患者符合纳入标准。这导致了483次急诊科随访运动医学诊所就诊。作者在急诊科每周工作13小时，在基层医疗运动医学实践中每周工作16小时，共产生1536小时的运动医学诊所工作时间。研究组占作者基层医疗运动医学实践中患者总量的20%。有111例下肢损伤（膝关节52%，足/踝40%，髋/骨盆8%），81例上肢损伤（手/腕48%，肩43%，肘9%），以及7例脊柱损伤。付费方构成情况为：传统 indemnity 占47%，健康维护组织（HMO）占45%，自费占4%，医疗保险/医疗补助占4%。急诊科随访运动医学诊所就诊的总费用为44767美元（每次就诊92.68美元），净收入为30276美元（每次就诊62.68美元）。这占该时期作者运动医学实践中总费用的20%和净收入的16%。急诊科随访运动医学诊所就诊产生的收入可支付全职急诊医学教员岗位基本工资同等成本的12%。
将基层医疗运动医学纳入学术急诊医学教员实践可通过设立急诊科随访运动医学诊所来增加收入，同时也为扩大住院医师学习体验提供了机会。
