Joy S A, Lichtig L K, Knauf R A, Martin K, Yurt R W
Department of Surgery, Cornell University Medical College, New York, NY 10021.
J Trauma. 1994 Aug;37(2):303-8; discussion 308-13. doi: 10.1097/00005373-199408000-00024.
Medical and demographic data for trauma patients (n = 7120) admitted to 12 trauma centers in 1 year were reviewed. Data from New York State on all discharges for the same year (n = 2,535,501) were obtained and analyzed. Patients were identified as trauma patients based on NYC EMS trauma center advisory committee criteria translated into ICD-9-CM codes, and a computer-based algorithm was developed that identified 43,219 trauma patients. A standard resource cost (SRC) was also developed to compare relative cost among trauma and non-trauma patients in the same diagnosis-related groups (DRGs). The mean age of the 43,219 trauma patients was 43.1 years, 61.8% were male, the mean LOS was 13.4 days, the mean ISS was 10.4, and 61% were discharged from community hospitals. Trauma centers treated the more severely injured patients: mean ISSs were 12.3, 10.9, and 9.2 for level I, level II, and community hospitals, respectively. Payor mix varied by category, with 71% of penetrating trauma victims covered by Medicaid or self pay compared with 21% of blunt trauma victims. Level I centers treated twice as many self-pay and Medicaid patients as community hospitals. A comparison of relative cost showed that trauma patients cost 27.5 million dollars more than non-trauma patients in the same DRGs.
对1年内收治于12家创伤中心的7120例创伤患者的医学和人口统计学数据进行了回顾。获取并分析了纽约州同一年所有出院患者的数据（n = 2,535,501）。根据纽约市紧急医疗服务创伤中心咨询委员会标准转化为ICD - 9 - CM编码来确定患者为创伤患者，并开发了一种基于计算机的算法，该算法识别出43219例创伤患者。还制定了标准资源成本（SRC），以比较同一诊断相关组（DRG）中创伤患者和非创伤患者的相对成本。43219例创伤患者的平均年龄为43.1岁，61.8%为男性，平均住院时间为13.4天，平均损伤严重度评分（ISS）为10.4，61%从社区医院出院。创伤中心治疗的患者伤势更严重：一级、二级和社区医院的平均ISS分别为12.3、10.9和9.2。支付方构成因类别而异，71%的穿透伤受害者由医疗补助或自费支付，而钝挫伤受害者这一比例为21%。一级中心治疗的自费和医疗补助患者数量是社区医院的两倍。相对成本比较显示，在相同的DRG中，创伤患者比非创伤患者多花费2750万美元。
