Department of Surgery, Division of Acute Care Surgery, University of Missouri Frank L. Mitchell, Jr, MD, Trauma Center, University Hospital, Columbia, MO, USA.
Surgery. 2010 Oct;148(4):793-7; discussion 797-8. doi: 10.1016/j.surg.2010.07.040. Epub 2010 Aug 24.
The dichotomy between clinical and hospital revenue generation for trauma care is well established. Many trauma programs require hospital support for fiscal survival. We evaluated the impact of standardized clinical documentation to the hospital's bottom line at our trauma center.
Standardized documentation templates for evaluation and management were created with a focus on accuracy and efficiency. Documentation was completed jointly by residents and faculty following standard guidelines of linkage. Trauma service characteristics, case mix index, reimbursement rate, payer distribution, hospital charges, cost, and payments were compared before and after standardization. Professional revenue was not evaluated. Analysis was performed using a commercially available spreadsheet computer application.
A 24% increase in the hospital's net income for trauma care, constituting $1.45 million, was realized despite a 12% decrease in patient volume. Admission profitability increased by 42%. Collection rates and payer mix were unchanged. Increases in both injury severity score and case mix index were seen (P < .05) after implementation of the program. Length of stay was decreased significantly.
An effective standardized documentation strategy for trauma care results in significant fiscal gains in hospital reimbursement.
创伤护理的临床和医院收入之间的二分法是众所周知的。许多创伤项目需要医院的财政支持才能维持生存。我们评估了在我们的创伤中心，标准化临床文档对医院底线的影响。
创建了评估和管理的标准化文档模板，重点是准确性和效率。住院医师和教员按照链接的标准指南共同完成文档。在标准化前后比较了创伤服务特征、病例组合指数、报销率、支付方分布、医院收费、成本和支付情况。未评估专业收入。使用商业上可用的电子表格计算机应用程序进行分析。
尽管患者数量减少了 12%，但创伤护理的医院净收入增加了 24%，达到 145 万美元。入院盈利能力增加了 42%。收费率和支付方组合保持不变。在实施该计划后，伤害严重程度评分和病例组合指数均增加（P<0.05）。住院时间显著缩短。
创伤护理的有效标准化文档策略可显著提高医院报销的财政收益。
