Trauma Care:

Lifesaving System Threatened by Unreimbursed Costs and Other Factors

HRD-91-57: Published: May 17, 1991. Publicly Released: May 23, 1991.

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Pursuant to a congressional request, GAO provided information on the factors that influence urban area trauma center closures.

GAO found that: (1) the average charge per hospital admission for a trauma patient is three times higher than that for regular acute-care admission; (2) of the 35 trauma centers reviewed, 15 have closed, 12 primarily because of financial losses; (3) trauma systems could reduce the trauma death rate by as much as 64 percent, since they offered the immediate availability of specialized services on a 24-hour basis; (4) unreimbursed costs from providing trauma care to the uninsured and government-assisted program beneficiaries were the principal causes of trauma center closures; (5) an area trauma system could become overburdened and deteriorate when some of its trauma centers close; (6) trauma care interrupted hospital services and routines; (7) nontrauma patients may react negatively to such disruptions as delayed services and rescheduling of tests and surgeries, caused by trauma patients; and (8) trauma care negatively affected trauma physicians due to its unpredictable nature.

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