Factors that enhance continued trauma center participation in trauma systems
Factors that enhance continued trauma center participation in trauma systems
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DOI：
10.1097/00005373-199611000-00021
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发表时间：
1996-11-01
影响因子：
--
通讯作者：
Chan, C
中科院分区：
文献类型：
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作者：
Bazzoli, GJ;Meersman, PJ;Chan, C
目的：研究医院创伤系统和补偿因素，抵消创伤护理交付的财政负担，并评估拟议的医疗补助和医疗保险预算车辙mag如何影响医院减轻创伤护理交付相关的财政压力的能力。设计和设置：锌深度访谈和数据收集创伤中心在12个大都市地区的人口100万或更多。参与者：这些大型城市社区的70个创伤中心表示在可预见的未来继续致力于提供创伤服务，主要结果指标：医院，创伤中心，和报销特点，区分医院，更好地减轻贫困创伤护理的财务负担和财务分析，评估支付充分不同的铺路人和整体财务结果，数据来源：从各种来源获得的数据来衡量影响创伤中心的运营和融资的因素：来自美国医院协会的已发表和未发表的医院数据;创伤中心水平，运营时间，以及最近发表的研究中的替代中心的可用性;医疗保险和医疗补助计划特征的医疗保健融资管理数据;汽车保险要求：和病人出院数据。大多数数据反映了1992年的情况。公立医院、教学医院和接受补充贫困护理付款的机构似乎最有能力减轻无补偿创伤护理的经济负担，特别是那些中等贫困护理负担的机构，一项详细的财务分析发现，设有创伤中心的私立医院接近破产-即使在1992年的创伤护理服务和公立医院经历了财政损失，建议减少医疗补助和医疗保险将创造大量减少医院支付的医院范围内的病人的医疗费用和创伤病人特别。拟议中的医疗补助和医疗保险支付削减可能会消除许多城市医院在提供创伤护理方面取得的微妙的财务平衡，来自公共项目的资金侵蚀可能预示着新一轮创伤中心关闭的浪潮，因为医院试图通过消除无利可图的项目来应对报销减少的问题。服务
Objectives: To examine hospital trauma system, and reimbursement factors that offset the financial burdens of trauma care delivery and to assess how proposed Medicaid and Medicare budget ruts mag affect the ability of hospitals to alleviate financial pressures related to trauma care delivery.Design and Setting: Zn-depth interviews and data collection for trauma centers in 12 metropolitan areas with populations of 1 million or more.Participants: Seventy trauma centers in these large urban communities that indicated a continuing commitment to providing trauma services for the foreseeable future,Main Outcome Measures: Hospital, trauma system, and reimbursement characteristics that distinguish hospitals that are better able to alleviate the financial burdens of indigent trauma care and a financial analysis that assesses payment adequacy for different pavers and overall financial outcomes,Data Sources: Data from a variety of sources were obtained to measure the factors that affect the operation and financing of trauma centers: published and unpublished hospital data from the American Hospital Association; trauma center level, length of operation, and the availability of alternative centers from a recently published study; Health Care Financing Administration data on Medicare and Medicaid program characteristics; automobile insurance requirements: and patient discharge data. Most data are reflective of 1992.Results: Public hospitals, teaching hospitals, and institutions receiving supplemental indigent care payments appear to be best able to mitigate the financial burdens of uncompensated trauma care, especially those with moderate indigent care loads, A detailed financial analysis found that private hospitals with trauma centers were near break-even in 1992 for trauma care delivery and public hospitals experienced financial losses, Proposals to reduce Medicaid and Medicare would create substantial reductions in hospital payments for hospital-wide patient tare and trauma patients specially.Conclusion: Proposed Medicaid and Medicare payment cuts are likely to eliminate the delicate financial balance that many urban hospitals have achieved in providing trauma care, The erosion in funding from public programs may portend a new wave of trauma center closures as hospitals seek to deal with reduced reimbursement by eliminating unprofitable services.