PATTERNS OF TRAUMA CARE COSTS AND REIMBURSEMENTS: THE BURDEN OF UNINSURED MOTORISTS

In today's rapidly changing medical-economic environment, hospitals must continually reexamine their services to determine which are cost efficient. We used a database system to analyze our financial experience with motor vehicle accident victims discharged between July 1982 and June 1983. We found that motor vehicle accidents accounted for 2.1% of discharges, but 6.6% of patient-days. The average length of stay was 23.8 days, more than three times the hospital average (7.4 days). Charges averaged $723 per day, essentially identical with the hospital average. In terms of patient-days, 51% of accident victims were covered by private insurance, 39% by Medi-Cal (California's Medicaid), and 3% by Medicare; 7% were uninsured and unsponsored. Hospital charges related directly to patient-days and were identical for the four financial categories. Overall reimbursement for these patients was 80.3% of charges, approximately equal to our estimated costs. Reimbursement as a percentage of charges varied greatly according to the category of sponsorship: private insurance, 90%; Medicare, 78%; and unsponsored, 15%. Medi-Cal paid a fixed confidential per diem rate. The following conclusions were drawn: 1) Caring for victims of motor vehicle accidents was a break-even proposition for our institution in 1982-1983. 2) Uninsured and unsponsored patients produced a large deficit which of necessity had to be made up by cost shifting to privately insured patients or by direct tax subsidies. 3) Motor vehicle insurance per se made only a modest contribution to our reimbursement for the care of these patients. 4) Although individuals at risk for motor vehicle accidents can be identified and should therefore be insurable, a substantial number of people will drive without motor vehicle insurance--in spite of "compulsory" laws. 5) Without continued cost shifting or governmental subsidies at some level, it is unlikely that comprehensive trauma care can continue to be made available to all segments of the population.

• Availability:
  • Find a library where document is available. Order URL: http://worldcat.org/issn/00225282
• Corporate Authors:

  Lippincott Williams & Wilkins

  428 East Preston Street
  Baltimore, MD  United States  21202
• Authors:
  • Oakes, D D
  • Holcomb, S F
  • Sherck, J P
• Publication Date: 1985-8

Media Info

• Features: References; Tables;
• Pagination: p. 740-745
• Serial:
  • Journal of Trauma, Injury, Infection and Critical Care
  • Volume: 25
  • Issue Number: 8
  • Publisher: Lippincott Williams & Wilkins
  • ISSN: 0022-5282

Subject/Index Terms

• TRT Terms: Automobile insurance; Benefit cost analysis; Costs; Crash victims; Crashes; Deficits; Health care; Hospitals; Insurance; Subsidies
• Uncontrolled Terms: Accident costs; Medical costs; Uninsured motorists
• Old TRIS Terms: Cost shifting; Reimbursable costs
• Subject Areas: Finance; Safety and Human Factors;

Filing Info

• Accession Number: 00453266
• Record Type: Publication
• Source Agency: National Highway Traffic Safety Administration
• Report/Paper Numbers: HS-039 380
• Files: HSL, USDOT
• Created Date: Feb 28 1986 12:00AM