• J. Pediatr. Surg. · Jun 2007

    Pediatric trauma care: a profitable enterprise?

    • Jordan R Gutweiler and David P Mooney.
    • Department of Surgery, Children's Hospital Boston and Harvard Medical School, Boston, MA 02115, USA.
    • J. Pediatr. Surg. 2007 Jun 1; 42 (6): 1043-5; discussion 1045-6.

    PurposeWe set out to examine whether pediatric trauma care resulted in a financial burden.MethodsWe reviewed financial data for children with an International Classification of Diseases, Ninth Edition, injury diagnosis code over 2 years at an urban level I pediatric trauma center. We divided inpatients into length of stay categories, and profit or loss was calculated for each payor/length of stay category. These figures were then used to estimate revenue for each hospital based upon their patients payor/length of stay distribution that was obtained from the KID database. Our payor-based outpatient revenue figures were also applied to the other hospital-calculated outpatient visits to obtain an estimate of their outpatient revenues.ResultsWe treated 49,437 injured children with a revenue balance of more than $8 million. Commercial insurance resulted in a positive revenue stream. Losses increased as length of stay increased for patients with Medicaid or self-pay. Outpatient encounters resulted in 59% of the revenue. Extrapolating our data, 84% of pediatric trauma centers in 27 states generate an average of $800,000 revenue.ConclusionsPediatric trauma care is a profitable enterprise. Inadequate reimbursement remains for Medicaid and self-pay patients, which could result in financial losses should this proportion of the patient mix be more than 55%.

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