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Trauma centers in a managed care environment

A R Campbell1, E Vittinghoff, D Morabito

  • 1Department of Surgery, University of California, San Francisco, USA.

The Journal of Trauma
|August 1, 1995
PubMed
Summary
This summary is machine-generated.

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Trauma centers must analyze patient subsets to negotiate managed care contracts. Severely injured patients drive costs, and early transfer may improve cost efficiency for health maintenance organizations.

Area of Science:

  • Trauma Surgery
  • Health Services Research
  • Healthcare Management

Background:

  • Health care reform impacts trauma center relationships with managed care organizations.
  • Understanding patient transfer, length of stay, and costs is crucial for trauma centers.

Purpose of the Study:

  • To identify predictors of repatriation for Kaiser Permanente members from San Francisco General Hospital (SFGH).
  • To compare length of stay (LOS) and costs between Kaiser and non-Kaiser patients.
  • To inform negotiations between trauma centers and managed care plans.

Main Methods:

  • Retrospective analysis of 7,794 trauma patients admitted to SFGH before 1994.
  • Matched cohort study comparing 89 Kaiser patients with non-Kaiser controls on injury severity and demographics.

Related Experiment Videos

  • Statistical analysis to determine predictors of repatriation and compare LOS and costs.

    • Main Results:

    • Kaiser patients were younger, had more blunt injuries, and lower mortality.
    • Predictors of repatriation included higher Abbreviated Injury Scale (AIS) scores, abdominal/extremity injuries, and Injury Severity Score (ISS) ranges.
    • Repatriated Kaiser patients had significantly longer LOS (16 days) compared to controls (7.8 days).

    Conclusions:

    • Severely injured patients represent a significant cost burden in trauma care.
    • Trauma centers need to analyze patient subsets for effective managed care negotiations.
    • Further research is needed on the cost-efficiency of early transfer for managed care patients.