TY - JOUR
T1 - How much green does it take to be orange? Determining the cost associated with trauma center readiness
AU - Georgia Research Institute for Trauma Study Group
AU - Ashley, Dennis W.
AU - Mullins, Robert F.
AU - Dente, Christopher J.
AU - Johns, Tracy J.
AU - Garlow, Laura E.
AU - Medeiros, Regina S.
AU - Atkins, Elizabeth V.
AU - Solomon, Gina
AU - Abston, Dena
AU - Ferdinand, Colville H.
AU - Bhatia, Amina
AU - Hill, Karen
AU - Rhee, Peter
AU - Dunne, James
AU - Armola, Rochelle
AU - Wyrzkowski, Amy
AU - Sargent, Jim
AU - Cascone, John
AU - Stitely, Daphne
AU - Bleacher, John
AU - Walton, Tracie
AU - McKemie, Clarence
AU - Parris, Melissa
AU - Massoud, Romeo
AU - Nicholas, Jeffrey
AU - Paynter, Steven
AU - Brown, Kim
AU - Hannay, Scott
AU - Baggett, Leslie
AU - Creel, Nathan
AU - Gibson, Jesse
AU - Hawk, Thomas
AU - Morgan, Heather
AU - Renz, Barry
AU - Gravlee, Mark
AU - Mardhekar, Aruna
AU - Postoev, Angelina
AU - Cox, Melanie
AU - Mayfield, Kelly
AU - Carnes, Jaina
AU - Campbell, Robert
AU - Jones, Alex
AU - Scheirer, Robert
AU - Mercer, Misty
AU - Thompson, Michael
AU - Napier, Joni
AU - Sy, John
AU - Shores, Dana
AU - Headley, Brad
AU - Thornton, Gail
N1 - Publisher Copyright:
© 2019 Wolters Kluwer Health, Inc. All rights reserved.
PY - 2019/5/1
Y1 - 2019/5/1
N2 - BACKGROUND Readiness costs are real expenses incurred by trauma centers to maintain essential infrastructure to provide emergent services on a 24/7 basis. Although the components for readiness are well described in the American College of Surgeons' Resources for Optimal Care of the Injured Patient, the cost associated with each component is not well defined. We hypothesized that meeting the requirements of the 2014 Resources for Optimal Care of the Injured Patient would result in significant costs for trauma centers. METHODS The state trauma commission in conjunction with trauma medical directors, program managers, and financial officers of each trauma center standardized definitions for each component of trauma center readiness cost and developed a survey tool for reporting. Readiness costs were grouped into four categories: administrative/program support staff, clinical medical staff, in-house operating room, and education/outreach. To verify consistent cost reporting, a financial auditor analyzed all data. Trauma center outliers were further evaluated to validate variances. All level I/level II trauma centers (n = 16) completed the survey on 2016 data. RESULTS Average annual readiness cost is US $10,078,506 for a level I trauma center and US $4,925,103 for level IIs. Clinical medical staff was the costliest component representing 55% of costs for level Is and 64% for level IIs. Although education/outreach is mandated, levels I and II trauma centers only spend approximately US $100,000 annually on this category (1%-2%), demonstrating a lack of resources. CONCLUSION This study defines the cost associated with each component of readiness as defined in the Resources for Optimal Care of the Injured Patient manual. Average readiness cost for a level I trauma center is US $10,078,506 and US $4,925,103 for a level II. The significant cost of trauma center readiness highlights the need for additional trauma center funding to meet the requirements set forth by the American College of Surgeons.
AB - BACKGROUND Readiness costs are real expenses incurred by trauma centers to maintain essential infrastructure to provide emergent services on a 24/7 basis. Although the components for readiness are well described in the American College of Surgeons' Resources for Optimal Care of the Injured Patient, the cost associated with each component is not well defined. We hypothesized that meeting the requirements of the 2014 Resources for Optimal Care of the Injured Patient would result in significant costs for trauma centers. METHODS The state trauma commission in conjunction with trauma medical directors, program managers, and financial officers of each trauma center standardized definitions for each component of trauma center readiness cost and developed a survey tool for reporting. Readiness costs were grouped into four categories: administrative/program support staff, clinical medical staff, in-house operating room, and education/outreach. To verify consistent cost reporting, a financial auditor analyzed all data. Trauma center outliers were further evaluated to validate variances. All level I/level II trauma centers (n = 16) completed the survey on 2016 data. RESULTS Average annual readiness cost is US $10,078,506 for a level I trauma center and US $4,925,103 for level IIs. Clinical medical staff was the costliest component representing 55% of costs for level Is and 64% for level IIs. Although education/outreach is mandated, levels I and II trauma centers only spend approximately US $100,000 annually on this category (1%-2%), demonstrating a lack of resources. CONCLUSION This study defines the cost associated with each component of readiness as defined in the Resources for Optimal Care of the Injured Patient manual. Average readiness cost for a level I trauma center is US $10,078,506 and US $4,925,103 for a level II. The significant cost of trauma center readiness highlights the need for additional trauma center funding to meet the requirements set forth by the American College of Surgeons.
KW - Readiness costs
KW - survey
KW - trauma center
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U2 - 10.1097/TA.0000000000002213
DO - 10.1097/TA.0000000000002213
M3 - Article
C2 - 30768564
AN - SCOPUS:85065101156
SN - 2163-0755
VL - 86
SP - 765
EP - 773
JO - Journal of Trauma and Acute Care Surgery
JF - Journal of Trauma and Acute Care Surgery
IS - 5
ER -