A quantitative method for cost reimbursement and length of stay quality assurance in multiple trauma patients

Objective: To develop a statistically valid method for trauma reimbursement and quality assurance (QA) length-of-stay filters. This is needed because diagnosis related group (DRG)-based trauma payment systems assume a random sampling of injury severities from a normally distributed population and thus result in economic disincentives to level I trauma centers. Methods: 142 trauma patients with MVC blunt multisystem injuries (MSI) (ISS≥16) were studied concurrently during their hospital course. Setting: Level I regional trauma center. Outcome Measures: Outcome measures were (dependent variables) length of stay (LOS) and state-approved hospital charges (COST). Results: Mean acute care COST was $74,310, but the distribution of COST was log normal, rather than Gaussian normal as assumed by DRGs