Clancy T V, Misick L N, Covington D, Churchill M P, Maxwell J G
Department of Surgery, University of North Carolina School of Medicine, Chapel Hill.
J Trauma. 1994 Jul;37(1):1-4. doi: 10.1097/00005373-199407000-00001.
The purpose of this study was to examine the financial impact of assault-related penetrating trauma. We specifically reviewed hospital charges and reimbursement data. Two hundred eleven patients were identified from our Trauma Registry in a 4-year period: 108 with firearm injuries and 103 with injuries related to cutting or piercing instruments. Assault-related penetrating injuries generated more than $2,000,000 in hospital charges. Sixty-seven percent of this amount was incurred by patients who had no source of third-party payment. Reimbursement covered only 30% of charges. There were no differences in demographics, procedures, or in insurance status, mean charges, and unpaid balances between patients directly admitted and those transferred from other hospitals. Financial losses incurred by community hospitals from the care of penetrating injuries are substantial, and must be borne by cost shifting or other strategies. No evidence of "dumping" was found among this group of patients. The specter of injury caused by intentional violence extends beyond urban trauma centers, and has a serious negative financial impact on community trauma centers.
本研究的目的是考察与袭击相关的穿透性创伤的财务影响。我们专门审查了医院收费和报销数据。在4年期间，从我们的创伤登记处识别出211名患者：108名有火器伤，103名有与切割或穿刺器械相关的损伤。与袭击相关的穿透性损伤产生了超过200万美元的医院收费。其中67%由没有第三方支付来源的患者产生。报销仅覆盖30%的收费。直接入院的患者与从其他医院转来的患者在人口统计学、治疗程序、保险状况、平均收费和未付余额方面没有差异。社区医院因治疗穿透性损伤而产生的财务损失巨大，必须通过成本转移或其他策略来承担。在这组患者中未发现“甩卖”的证据。故意暴力造成的伤害阴影不仅影响城市创伤中心，还对社区创伤中心产生严重的负面财务影响。
