• Paul A Taheri, David A Butz, Larry Lottenberg, Art Clawson, and Lewis M Flint.
• Department of Surgery, Division of Trauma Burn and Emergency Surgery, University of Michigan Health System, 1c421 University Hospital, Box 0033, Ann Arbor, MI 48109-0033, USA. taheri@umich.edu
• Am. J. Surg. 2004 Jan 1; 187 (1): 7-13.

BackgroundTrauma centers and the services they provide are a unique and necessary component of our health system. By design trauma centers treat all injured patients regardless of their clinical or economic needs. The purpose of this study was to quantify the costs associated with the preparation of the capacity to provide trauma care at trauma centers within the State of Florida.MethodsUtilizing a survey tool and multiple retreats, we assessed the capability of 20 verified trauma centers throughout the State of Florida. The survey focused on general attributes of each hospital, the costs associated with physician on call coverage, costs associated with verification, and lastly the costs associated with administration, outreach, and prevention.ResultsData were acquired from 10 trauma centers. Ninety percent of the respondents pay on-call coverage. The median annual physician compensation for on-call coverage was approximately 2.1 million US dollars. The total medial cost of readiness for each trauma center approximated 2.7 million US dollars annually.ConclusionsTrauma centers like fire departments and police services are required to be available 24 hours a day, 7 days a week. This level of commitment by trauma centers and the reciprocal expectation from the community force trauma centers to make considerable investments in readiness. This cost of readiness is expended regardless of the patient volume or insurance status. Thus trauma centers have a large component of costs that are not captured by the traditional billing and cost accounting mechanisms within health systems and this fixed expense is extraordinarily difficult to recover given the current reimbursement environment.

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