BACKGROUND: The establishment of acute care surgery is rapidly becoming a solution to meet emergency surgical needs. Challenges include competition for emergency surgery opportunities and the ability to economically sustain a practice. METHODS: Clinical activity was measured by reviewing the institutional and practice plan databases. Work relative value units and practice plan collection rates defined clinical activity and revenue. RESULTS: Operative procedures and intensive care unit activity accounted for 52% and 36% of activity, respectively. Although procedures on the digestive tract accounted for half of the operative activity, significant activity was observed in nearly all other systems. Overall clinical productivity remained constant but did demonstrate a 25% increase in operative work relative value units. Current billing activity supports 4.0 clinical full-time equivalents, but estimated collections would cover <73% of physician direct costs. CONCLUSIONS: The authors describe the implementation of an acute care surgery service that combines trauma, emergency general surgery, and surgical critical care in an established academic surgery department. Developing a sustainable economic model must include income sources other than patient service revenue.
BACKGROUND: The establishment of acute care surgery is rapidly becoming a solution to meet emergency surgical needs. Challenges include competition for emergency surgery opportunities and the ability to economically sustain a practice. METHODS: Clinical activity was measured by reviewing the institutional and practice plan databases. Work relative value units and practice plan collection rates defined clinical activity and revenue. RESULTS: Operative procedures and intensive care unit activity accounted for 52% and 36% of activity, respectively. Although procedures on the digestive tract accounted for half of the operative activity, significant activity was observed in nearly all other systems. Overall clinical productivity remained constant but did demonstrate a 25% increase in operative work relative value units. Current billing activity supports 4.0 clinical full-time equivalents, but estimated collections would cover <73% of physician direct costs. CONCLUSIONS: The authors describe the implementation of an acute care surgery service that combines trauma, emergency general surgery, and surgical critical care in an established academic surgery department. Developing a sustainable economic model must include income sources other than patient service revenue.
Authors: B R Bruns; M Lissauer; R Tesoriero; M Narayan; L Buchanan; S M Galvagno; Jose Diaz Journal: Eur J Trauma Emerg Surg Date: 2015-05-19 Impact factor: 3.693
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Authors: Heena P Santry; John C Madore; Courtney E Collins; M Didem Ayturk; George C Velmahos; L D Britt; Catarina I Kiefe Journal: J Trauma Acute Care Surg Date: 2015-01 Impact factor: 3.313
Authors: Ram Venkatesh Anantha; Dave Paskar; Kelly Vogt; Silvie Crawford; Neil Parry; Ken Leslie Journal: World J Emerg Surg Date: 2014-03-27 Impact factor: 5.469