Gutweiler Jordan R, Mooney David P
Department of Surgery, Children's Hospital Boston and Harvard Medical School, Boston, MA 02115, USA.
J Pediatr Surg. 2007 Jun;42(6):1043-5; discussion 1045-6. doi: 10.1016/j.jpedsurg.2007.01.040.
We set out to examine whether pediatric trauma care resulted in a financial burden.
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.
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.
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%.
我们着手研究儿科创伤护理是否会带来经济负担。
我们回顾了一家一级城市儿科创伤中心超过2年时间里患有《国际疾病分类》第九版损伤诊断编码的儿童的财务数据。我们将住院患者按住院时间分类，并计算每个付款方/住院时间类别的盈利或亏损。然后根据从儿童住院数据库获得的各医院患者付款方/住院时间分布，使用这些数据来估算每家医院的收入。我们基于付款方的门诊收入数据也应用于其他医院计算出的门诊就诊次数，以估算其门诊收入。
我们治疗了49437名受伤儿童，收入结余超过800万美元。商业保险带来了正向收入流。对于医疗补助或自费患者，随着住院时间增加，亏损也增加。门诊诊疗产生了59%的收入。根据我们的数据推断，27个州84%的儿科创伤中心平均创收80万美元。
儿科创伤护理是一项盈利业务。医疗补助和自费患者的报销不足，如果这类患者在患者组合中的比例超过55%，可能会导致经济损失。
