V. Polcz1, L. Podolsky1,2, m. bukur1, M. Polcz2, c. orbay2, I. Puente1, r. Farrington1, o. sizar1, a. Farooq1, F. Habib1,2 1Broward Health Medical Center,Trauma,Ft Lauderdale, FL, USA 2Florida International University,Surgery,Miami, FL, USA
Introduction:
Delivery of trauma care is financially challenging. Financial viability is largely dependent on the payer mix, which changes over time. We therefore sought to determine the changing payer mix for the period of 1997-2012. This information has the potential to offer insight into informed trauma system planning, and may improve outcomes and quality of care for patients regardless of payer status.
Methods:
The Healthcare Cost and Utilization Project Nationwide Inpatient Sample (HCUP-NIS) database was queried to identify payer status for total trauma admissions from 1997-2012. Data, stratified by payer status, was then abstracted for incidence, lengths of stay, charges, mortality and discharge status for patients within this period. The study period was divided into quartiles of 4 years each. Statistical analysis was performed using the ANOVA, and a p value of <0.05 was used to determine significance.
Results:
Over the 16-year study period, trauma admissions for patients with government-funded payer status have increased significantly over the time period assessed, with both Medicare (p<0.0001) and Medicaid (p<0.0001) showing a significant increase as a proportion of the total patient population. Admissions of patients to trauma with private insurance status, in contrast, have shown a significant decrease in proportion of the total patient population over the time period studied (p=0.002). Patients with no insurance (p=0.921) or other payer status (p=0.406) were observed to have no significant change in proportion of trauma patient population from 1997-2012. The results of this analysis are summarized in Table 1.
Conclusion:
Government-funded trauma care is rising at a significant rate, with Medicare and Medicaid-funded patients forming an increasing proportion of the trauma population. Funding from private insurers continues to decline, and the uninsured continue to impose a constant financial burden on trauma centers nationwide.
