Saywell R M, Woods J R, Rodman G H, Nyhuis A W, Bender L B, Phillips J D, Bock H C
School of Public and Environmental Affairs, Indiana University, Indianapolis 46223.
Ann Emerg Med. 1989 Jan;18(1):21-5. doi: 10.1016/s0196-0644(89)80305-1.
Trauma centers are now being perceived as financial burdens because of recent changes in trauma reimbursement for the Medicare Prospective Payment System population and the perception that collection rates are lower among trauma patients. We examined the demographic and clinical factors associated with the collection experience in a series of 114 trauma patients transferred by helicopter from the accident site to an inner-city trauma center. Factors affecting payment at 30, 60, 90, and 180 days included patient age, insurance class, and discharge status. While not as high as the collection rate for the facility as a whole, we found an average 71.2% collection rate for trauma patients at 180 days. As long as trauma reimbursement continues to be cost based for nonMedicare patients, collection rates remain an important consideration in determining the financial viability of trauma centers.
由于医疗保险预期支付系统人群的创伤报销政策近期发生了变化,以及人们认为创伤患者的收款率较低,创伤中心现在被视为财政负担。我们研究了114例从事故现场通过直升机转运至市中心创伤中心的创伤患者的人口统计学和临床因素与收款经历之间的关系。影响30天、60天、90天和180天付款情况的因素包括患者年龄、保险类别和出院状态。虽然创伤患者180天的收款率不如该机构整体的收款率高,但我们发现平均收款率为71.2%。只要非医疗保险患者的创伤报销继续以成本为基础,收款率仍然是决定创伤中心财务可行性的一个重要考虑因素。