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Volume 190, Issue 6, Pages 951-960 (December 2005)


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Economic modeling comparing trauma and general surgery reimbursement

Presented at the 57th Annual Meeting of the Southwestern Surgical Congress, San Antonio, Texas, April 10–12, 2005

John A. Aucar, M.D., M.S.H.I.aCorresponding Author Informationemail address, Lanis L. Hicks, Ph.D.b

Received 8 April 2005; received in revised form 8 August 2005

Abstract 

Background

The viability of trauma care as a surgical subspecialty is continually challenged by economic pressures related to reimbursement and opportunity costs.

Methods

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.

Results

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.

Conclusion

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.

a Department of Surgery, University of Missouri–Columbia, MC 418, One Hospital Drive, Columbia, MO 65212, USA

b Department of Health Management and Informatics, University of Missouri–Columbia, Columbia, MO, USA

Corresponding Author InformationCorresponding author. Tel.: +1-573-882-8157; fax: +1-573-884-4611.

PII: S0002-9610(05)00722-1

doi:10.1016/j.amjsurg.2005.08.023


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