THE ECONOMIC-STATUS OF TRAUMA CENTERS ON THE EVE OF HEALTH-CARE REFORM

An in-depth understanding of the economic problems confronting trauma centers is essential for their continued development and to address im pending changes of health care reform. A comprehensive financial and d emographic survey was sent to 839 hospitals identified as potential tr auma centers. A total of 313 surveys from 48 states were returned. Ext ensive information was collected in several areas including financial status (58% reported serious financial problems and 36% reported minor financial problems; 68% reported a financial loss), cost containment and management strategies, marketing, ''halo'' effect (53% reported po sitive effect), operational impacts, physician support (47% reported p roblems), malpractice (92% reported no special problem), role of auto insurance reimbursement, and access to rehabilitation. Detailed financ ial data of actual costs and reimbursements (95 respondents) were anal yzed with the costing method used by the Health Care Financing Adminis tration (HCFA). These data will allow us to develop better strategies to deal with the problems of uncompensated and underfunded trauma care and improve trauma center viability.