Robert M. Saywell

Financial analysis of an inner-city helicopter service: Charges versus collections

Trauma centers are now being perceived as financial burdens because of recent changes in trauma reimbursement for the Medicare Prospective Payment System population and the perception that collection rates are lower among trauma patients. We examined the demographic and clinical factors associated with the collection experience in a series of 114 trauma patients transferred by helicopter from the accident site to an inner-city trauma center. Factors affecting payment at 30, 60, 90, and 180 days included patient age, insurance class, and discharge status. While not as high as the collection rate for the facility as a whole, we found an average 71.2% collection rate for trauma patients at 180 days. As long as trauma reimbursement continues to be cost based for nonMedicare patients, collection rates remain an important consideration in determining the financial viability of trauma centers.

An analysis of reimbursement for outpatient medical care in an urban hospital emergency department

The investigators examined the demographic and clinical factors associated with the collection experience in a series of 786 patients who were treated in an urban hospital emergency department (ED) but not admitted to the hospital. They found that 57% of the total net charge of

Comparative Costs of a Cooperative Care Program Versus Inpatient Hospital Care for Obstetric Patients

150,489 had been paid within 180 days. This rate can be compared with an average inpatient collection rate of 85% at 180 days. Seven factors were found to account for the collection rate variation, making up 38.4% of the total variation. Age, gender, primary diagnosis, season of visit, time of arrival, and residence were not found to be main contributors. Insufficient collection rates may be an indication that EDs increasingly are becoming a financial risk to hospitals. The hospitals collection experience will become more important as an indicator of financial risk if the costs of operating EDs continue to escalate and collection rates do not improve. Both the costs of providing a service and the amount of the charge actually collected are valid concerns to those operating EDs.

Financial Analysis of an Inner-City Helicopter Service: Charges Versus Collections for Patients Transferred From Another Acute Care Facility

The cost of obstetric care delivered in a cooperative care unit was compared with the cost for similar patients treated in a traditional inpatient maternity unit. The study sample contained 1,683 consecutive patients representing 23 diagnosis categories. The analysis indicates that cooperative care patients had significantly lower total hospital costs. This cost savings persisted even when we controlled for case severity. The only exception was for the obstetric patient requiring intra-abdominal surgery. For fiscal year 1986, hospital cost savings for the 576 patients who used the cooperative care unit was

Estimating the Economic Impact of Secondhand Smoke on the Health of a Community

80,640 or approximately

Cost of hospitalizations for heart failure: Sodium retention versus other decompensating factors

105,000 in total patient charges. The majority of the savings came from a reduction in routine nursing services that are directly attributable to the cooperative care unit. We conclude that cooperative care can be an economically feasible alternative for most obstetric patients.

The Use of a Break‐even Analysis: Financial Analysis of a Fast‐track Program

Emergency helicopter services provided by trauma centers are now being perceived as contributing to the financial burden of the hospital because of recent changes in trauma reimbursement under the Medicare Prospective Payment System (PPS) and because of the general perception that collection rates are lower among trauma patients. The use of helicopters to transfer patients from one acute care facility to another may also be concentrating the patients with low collection rates at the receiving hospital. We examined retrospectively the demographic and clinical factors associated with the collection experience in a series of 288 trauma patients transferred by helicopter from another acute care facility to an inner-city hospital. Factors affecting payment at 180 and 360 days included patient age, insurance class, discharge status, and size of the hospital charge. As long as reimbursement continues to be cost-based for nonMedicare patients, collection rates remain an important consideration in determining the financial viability of using helicopters to transfer patients.

Dental Workforce Report of Indiana University School of Dentistry Graduates and Other Practicing Dentists in Indiana

Purpose. This study provides a model to estimate the health-related costs of secondhand smoke exposure at a community level. Model Development. Costs of secondhand smoke–related mortality and morbidity were estimated using national attributable risk values for diseases that are causally related to secondhand smoke exposure for adults and children. Estimated costs included ambulatory care costs, hospital inpatient costs, and loss of life costs based on vital statistics, hospital discharge data, and census data. Application of the Model. The model was used to estimate health-related costs estimates of secondhand smoke exposure for Marion County, Indiana. Attributable risk values were applied to the number of deaths and hospital discharges to determine the number of individuals impacted by secondhand smoke exposure. Results. The overall cost of health care and premature loss of life attributed to secondhand smoke for the study county was estimated to be

The Economic Impact of Secondhand Smoke on the Health of Residents and Employee Smoking on Business Costs in Marion County, Indiana for 2000

53.9 million in 2000—

Use of a breakdown analysis in emergency medicine: Analysis of a fast-track program

10.5 million in health care costs and