Economic modeling comparing trauma and general surgery reimbursement

The viability of trauma care as a surgical subspecialty is continually challenged by economic pressures related to reimbursement and opportunity costs. The literature was examined for articles focused on economic implications of a trauma focused surgical practice. Economic forecasting techniques wer...

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Bibliographic Details
Published in:The American journal of surgery 2005-12, Vol.190 (6), p.951-960
Main Authors: Aucar, John A., Hicks, Lanis L.
Format: Article
Language:English
Subjects:
Biological and medical sciences
Censuses
Codes
Compensation
Critical care
Economic model
Elective Surgical Procedures - economics
Fees & charges
General aspects
Hernias
Hospital Charges - statistics & numerical data
Hospital Charges - trends
Hospitals
Humans
Insurance, Health, Reimbursement - economics
Insurance, Health, Reimbursement - trends
Laparoscopy
Liver
Medical sciences
Medicare
Models, Economic
Ostomy
Physicians
Reimbursement
Surgery
Surgical practice
Tracheotomy
Trauma
Trauma care
Trauma centers
Trauma Centers - economics
United States
Wages & salaries
Workload - economics
Wounds and Injuries - economics
Wounds and Injuries - surgery
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Summary:The viability of trauma care as a surgical subspecialty is continually challenged by economic pressures related to reimbursement and opportunity costs. The literature was examined for articles focused on economic implications of a trauma focused surgical practice. Economic forecasting techniques were applied using a recalculating spreadsheet to examine charge and revenue generation comparing the effects of numerous variables affecting a trauma or general surgical service. Elective general surgery practices derive the majority of revenues from procedural services, whereas trauma practices derive the majority of revenues from evaluation and management. Only centers with high admission volume can expect trauma surgeons to cover salary and expenses, predictably in association with high opportunity costs. The differences in time, effort, and patient volume required for a trauma surgeon to generate revenues comparable to an elective practice are dramatic. The current system creates disincentives for surgeons to participate in trauma care.
ISSN:0002-9610
1879-1883
DOI:10.1016/j.amjsurg.2005.08.023