Identification and categorization of and cost for care of trauma patients: a study of 12 trauma centers and 43,219 statewide patients.

Medical and demographic data for trauma patients (n = 7120) admitted to 12 trauma centers in 1 year were reviewed. Data from New York State on all discharges for the same year (n = 2,535,501) were obtained and analyzed. Patients were identified as trauma patients based on NYC EMS trauma center advisory committee criteria translated into ICD-9-CM codes, and a computer-based algorithm was developed that identified 43,219 trauma patients. A standard resource cost (SRC) was also developed to compare relative cost among trauma and non-trauma patients in the same diagnosis-related groups (DRGs). The mean age of the 43,219 trauma patients was 43.1 years, 61.8% were male, the mean LOS was 13.4 days, the mean ISS was 10.4, and 61% were discharged from community hospitals. Trauma centers treated the more severely injured patients: mean ISSs were 12.3, 10.9, and 9.2 for level I, level II, and community hospitals, respectively. Payor mix varied by category, with 71% of penetrating trauma victims covered by Medicaid or self pay compared with 21% of blunt trauma victims. Level I centers treated twice as many self-pay and Medicaid patients as community hospitals. A comparison of relative cost showed that trauma patients cost 27.5 million dollars more than non-trauma patients in the same DRGs.