The Trauma Service Line: Revenue from subsequent injury and non-injury-related care.

Abstract

OBJECTIVE\nTo calculate the revenue generated for injury and non-injury related services after the initial injury event in an orthopaedic trauma population DESIGN:: Retrospective cohort study SETTING:: Single Level 1 trauma center PARTICIPANTS:: 440 adult trauma patients treated operatively for spine, pelvis, and/or upper or lower extremity fractures with ≥1 night stay INTERVENTION:: Operative fracture management MAIN OUTCOME MEASUREMENT:: Revenue for follow-up care and for non-injury-related indications for 24 months RESULTS:: Most patients returned for follow-up (92.3%), generating 6,704 visits with professional and technical collections of $8,135,022 and $37,292,722, respectively, per 1,000 unique patients. The greatest revenue was from rehabilitation services. Patients were less likely to return if they resided outside adjacent counties (OR=0.16), experienced a complication (OR=0.38), or were older (OR per 10-year increase: 0.66) (all p<0.0001). Over 70% of trauma patients were new to our System, accounting for 33% of all subsequent non-injury-related visits, most for primary care (25.6%). Males (OR=3.28, 95% CI: 1.08-9.93), non-Caucasians (OR=3.41; 95%CI: 1.41-8.28), and patients residing near the trauma center (OR=16.1, 95% CI: 2.13-121)) were more likely to return (p<0.0001). Realized non-injury-related professional and technical revenue was $506 per operative orthopaedic trauma case.\n\n\nCONCLUSION\nDemographics and outcomes predict likelihood of follow-up. Rehabilitation services account for the greatest revenue per patient. The greatest number of return visits were for primary care services; awareness of such services, especially in males and in those residing near the hospital system could improve retention.\n\n\nLEVEL OF EVIDENCE\nEconomic, Level IV.