Equivalent Outcomes, Higher Charges at For-Profit Trauma Centers

Abstract

INTRODUCTION: For-profit (FP) trauma centers (TCs), on average, charge significantly more for trauma care than notfor- profit (NFP) (TCs). Our goal was to determine hospital charges and incidence of complication based on TC ownership status (FP, NFP, and government (G)) for three diagnoses among patients with overall low injury severity. METHOD(S): We used Florida's Agency for Health Care Administration (AHCA) inpatient data for 2016-2017. The study population included patients aged 18-55 years who were treated at TCs, with an International Classification of Diseases-based ISS (ICISS) survival probability >= 0.85, no co-morbidities, discharge status as routine, and a principal diagnosis of proximal femur fracture, tibial fracture, or multiple unilateral rib fractures. Descriptive statistics compared variables at FP, NFP, and G hospitals. Linear and logistic regression modeling analyzed the associations between TC ownership type with hospital charges and injury complication. RESULT(S): A total of 972 patients met inclusion criteria. G (n = 275) and NFP (n = 334) TCs were more likely to care for Hispanic and African American patients (p < 0.001). Trauma charges at FP TCs were on average 3 times higher than NFPs and 7.2 times higher than G TCs. Risk adjusted complication were equivalent between FP and NFP TC types, while G TCs had lower risk of complication. CONCLUSION(S): G and NFP centers had equivalent or better outcomes as FP centers yet care at FP TCs was at least twice as much. Further studies are required to elucidate these discrepancies.