Dollars and Sense – The Financial Argument for Dedicated Post-Trauma Center Care

Abstract

Objective: The objective of the study was to demonstrate that creation of a Center for Trauma Survivorship (CTS) is not cost prohibitive but is a revenue generator for the institution. Background: A dedicated CTS has been demonstrated to increase adherence with follow-up visits and improve overall aftercare in severely injured patients discharged from the trauma center. A potential impediment to the creation of similar centers is its assumed prohibitive cost. Methods: This pre-and post-cohort study examines the financial impact of patients treated by the CTS. Patients in the PRE cohort were those treated in the year prior to CTS inception. Eligibility criteria are trauma patients admitted who are ≥18 years of age and have a NISS≥16 or ICU stay ≥2 days. Financial data was obtained from the hospital’s billing and cost accounting systems for a one-year time period following discharge. Results: There were 176 patients in the PRE and 256 in the CTS cohort. The CTS cohort generated 1623 subsequent visits vs. 748 in the PRE cohort. CTS patients underwent more follow-up surgery in their first year of recovery as compared to the PRE cohort (98 vs 26 procedures). Each CTS patient was responsible for a $7,752 increase in net revenue with a positive contribution margin of $4,558 compared to those in the PRE group. Conclusion: A dedicated CTS increases subsequent visits and necessary procedures and is a positive revenue source for the trauma center. The presumptive financial burden of a CTS is incorrect and the creation of dedicated centers will improve patients’ outcomes and the institution’s bottom line.