Dollars and sense: attributing value to a level I trauma center in economic terms

Reliable, accurate, program-specific data for hospital product lines are often difficult to obtain. The purpose of this study was to determine the impact that trauma center status has on hospital net income when compared with other traditional hospital product lines and services.

Over a 3-year period, financial data were collected for 16 payor classes: 8 major payors for all injury diagnoses, in-patient and out-patient. These data were analyzed by total charges, total direct costs, contribution margin, and net income. A key assumption of this strategy was that although injury patients are treated at most hospitals, only trauma center status allows access to patients and provision of services that can contribute significantly to the bottom line.

Over the 3-year period, the contribution margin increased for trauma patients (excluding Level I trauma), Level I trauma patients, and the combined population of trauma patients. The most significant portion of the increase resulted from patients seen as a result of trauma center status.

We conclude that, for our institution, the investment in resources necessary to achieve and maintain trauma center status makes economic sense in that the trauma program contributes favorably to hospital net revenue.