Division of Trauma and Surgical Critical Care (AG, PY, DHL), Department of Surgery, Rutgers-New Jersey Medical School, Newark, NJ.
Department of Hospital Finance, University Hospital, Newark, NJ.
Ann Surg. 2024 Aug 1;280(2):340-344. doi: 10.1097/SLA.0000000000006275. Epub 2024 Mar 19.
To demonstrate that the creation of a Center for Trauma Survivorship (CTS) is not cost-prohibitive but is a revenue generator for the institution.
A dedicated CTS has been demonstrated to increase adherence with follow-up visits and improve overall aftercare in severely injured patients discharged from the trauma center. A potential impediment to the creation of similar centers is its assumed prohibitive cost.
This pre and post-cohort study examines the financial impact of patients treated by the CTS. Patients in the PRE cohort were those treated in the year before CTS inception. Eligibility criteria are trauma patients admitted who are ≥18 years of age and have a New Injury Severity Score ≥16 or intensive care unit stay ≥2 days. Financial data were obtained from the hospital's billing and cost accounting systems for a 1-year time period after discharge.
There were 176 patients in the PRE and 256 in the CTS cohort. The CTS cohort generated 1623 subsequent visits versus 748 in the PRE cohort. CTS patients underwent more follow-up surgery in their first year of recovery as compared with the PRE cohort (98 vs 26 procedures). Each CTS patient was responsible for a $7752 increase in net revenue with a positive contribution margin of $4558 compared with those in the PRE group.
A dedicated CTS increases subsequent visits and necessary procedures and is a positive revenue source for the trauma center. The presumptive financial burden of a CTS is incorrect and the creation of dedicated centers will improve patients' outcomes and the institution's bottom line.
证明创建创伤幸存者中心（CTS）不会增加成本，反而会为机构带来收入。
已证明，专门的 CTS 可提高严重创伤患者从创伤中心出院后的随访依从性，并改善整体康复护理。创建类似中心的一个潜在障碍是其假设的高昂成本。
本研究采用前后队列设计，研究了 CTS 治疗患者的财务影响。PRE 队列中的患者是在 CTS 成立前一年接受治疗的患者。纳入标准为：年龄≥18 岁且新损伤严重程度评分≥16 分或入住重症监护病房≥2 天的创伤患者。财务数据来自出院后 1 年的医院计费和成本核算系统。
PRE 队列中有 176 例患者，CTS 队列中有 256 例患者。CTS 队列在恢复的第一年产生了 1623 次后续就诊，而 PRE 队列只有 748 次。与 PRE 队列相比，CTS 患者在第一年的康复期间接受了更多的后续手术（98 次与 26 次手术）。与 PRE 组相比，每位 CTS 患者增加了 7752 美元的净收入，边际贡献为 4558 美元。
专门的 CTS 可增加后续就诊和必要的手术次数，是创伤中心的正向收入来源。对 CTS 产生的财务负担的假设是不正确的，创建专门的中心将改善患者的预后并改善机构的底线。
