Financial impact of minor injury transfers on a level 1 trauma center

Nikolas S. Kappy, Joshua P. Hazelton, Lisa Capano-Wehrle, Robert Gibbs, Michael K. Dalton, Steven E. Ross

Research output: Contribution to journalArticle

Abstract

Background: Trauma centers frequently accept patients from other institutions who are being sent due to the need for a higher level of care. We hypothesized that patients with minor traumatic injuries who are transferred from outside institutions would impart a negative financial impact on the receiving trauma center. Methods: We performed a retrospective review of all trauma patients admitted to our urban level I trauma center from October 1, 2011, through September 30, 2013. Patients were categorized as minor trauma if they did not require operation within 24 h of arrival, did not require ICU admission, did not die, and had a hospital length of stay <24 h. Transferred patients and nontransfers (those received directly from the field) were compared with respect to injury severity, insurance status, and hospital net margin. Student's t-test and z-test for proportions were performed for data analysis. Results: A total of 6951 trauma patients were identified (transfer n = 2228, nontransfer n = 4724). Minor injury transfers (n = 440) were compared to nontransfers (n = 689). Hospital net margin of transferred patients and nontransferred patients were $2227 and $2569, respectively (P = 0.22). Percentages of uninsured/underinsured for transfers and nontransfers were 27.3% and 36.1%, respectively (P = 0.002). Conclusions: During our study period, 19.7% of transfers and 14.6% of nontransfers can be categorized as having minor trauma. Minor trauma transfer patients are associated with a positive hospital net margin for the trauma center that is similar to that of the nontransfer group. The data also demonstrate a lower percentage of uninsured/underinsured in the transferred group.

Original languageEnglish (US)
Pages (from-to)403-407
Number of pages5
JournalJournal of Surgical Research
Volume233
DOIs
StatePublished - Jan 2019

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Trauma Centers
Wounds and Injuries
Length of Stay
Patient Transfer
Insurance Coverage
Students

All Science Journal Classification (ASJC) codes

  • Surgery

Cite this

Kappy, Nikolas S. ; Hazelton, Joshua P. ; Capano-Wehrle, Lisa ; Gibbs, Robert ; Dalton, Michael K. ; Ross, Steven E. / Financial impact of minor injury transfers on a level 1 trauma center. In: Journal of Surgical Research. 2019 ; Vol. 233. pp. 403-407.
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Financial impact of minor injury transfers on a level 1 trauma center. / Kappy, Nikolas S.; Hazelton, Joshua P.; Capano-Wehrle, Lisa; Gibbs, Robert; Dalton, Michael K.; Ross, Steven E.

In: Journal of Surgical Research, Vol. 233, 01.2019, p. 403-407.

Research output: Contribution to journalArticle

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T1 - Financial impact of minor injury transfers on a level 1 trauma center

AU - Kappy, Nikolas S.

AU - Hazelton, Joshua P.

AU - Capano-Wehrle, Lisa

AU - Gibbs, Robert

AU - Dalton, Michael K.

AU - Ross, Steven E.

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N2 - Background: Trauma centers frequently accept patients from other institutions who are being sent due to the need for a higher level of care. We hypothesized that patients with minor traumatic injuries who are transferred from outside institutions would impart a negative financial impact on the receiving trauma center. Methods: We performed a retrospective review of all trauma patients admitted to our urban level I trauma center from October 1, 2011, through September 30, 2013. Patients were categorized as minor trauma if they did not require operation within 24 h of arrival, did not require ICU admission, did not die, and had a hospital length of stay <24 h. Transferred patients and nontransfers (those received directly from the field) were compared with respect to injury severity, insurance status, and hospital net margin. Student's t-test and z-test for proportions were performed for data analysis. Results: A total of 6951 trauma patients were identified (transfer n = 2228, nontransfer n = 4724). Minor injury transfers (n = 440) were compared to nontransfers (n = 689). Hospital net margin of transferred patients and nontransferred patients were $2227 and $2569, respectively (P = 0.22). Percentages of uninsured/underinsured for transfers and nontransfers were 27.3% and 36.1%, respectively (P = 0.002). Conclusions: During our study period, 19.7% of transfers and 14.6% of nontransfers can be categorized as having minor trauma. Minor trauma transfer patients are associated with a positive hospital net margin for the trauma center that is similar to that of the nontransfer group. The data also demonstrate a lower percentage of uninsured/underinsured in the transferred group.

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