Economic problem of referred trauma cases in Siriraj Hospital

Abstract

To improve the service for referred trauma patients, the authors have to know the types of injury, the cost, and the reimbursement for each individual category. Therefore, the authors studied the characteristics of accident of patients transferred for treatment at Siriraj Hospital, including types of trauma (wounds), cost of treatment (excluding doctor's fees) and charges for treatments for each group. There were 678 trauma cases referred to the Division of Trauma Surgery, Department of Surgery, Faculty of Medicine, Siriraj Hospital from 1 st September 2002 to 31 st August 2003 and of these, 571 cases were admitted. From the admitted cases, the most common injury was the musculoskeletal system (38.6%), followed by nervous system injury (15.1%), eye injury (8.1%), toxic substance injury (6.3%), burns (5.8%), and others. The total cost of treatment was 36,249,150 baht. The reimbursement was 30,135,709 baht. There were four categories where the reimbursed amount was below the actual cost. They were burns, followed by nervous system injury, eye injury and skin or subcutaneous tissue injury. To deal with the referred cases in trauma center level I, the center should prepare to manage the common trauma groups such as musculoskeletal system injury, nervous system injury and eye injury. Burns, nervous system injury, eye injury and skin or subcutaneous tissue injuries are the major groups that cost more than the reimbursement amount. The reimbursement of these groups should be reconsidered in the future to solve the problem.