Does Fracture Care Make Money for the Hospital? An Analysis of Hospital Revenues and Costs for Treatment of Common Fractures

J Orthop Trauma. 2015 Jul;29(7):e219-24. doi: 10.1097/BOT.0000000000000263.

Abstract

Objectives: To determine the relative profitability for a hospital of treatment of common fractures within a state-regulated reimbursement system.

Design: Retrospective cohort.

Setting: Regional trauma referral center with state-regulated hospital reimbursement system.

Methods: We reviewed hospital medical and financial records of 1228 patients admitted from 2008 through 2012 with a principle diagnosis of acute traumatic fracture requiring surgical treatment. Patients whose principle diagnosis fit into 1 of 6 common anatomic categories were included. Sixty-five pelvic, 275 acetabular, 277 hip, 255 femoral shaft, 148 tibial shaft, and 208 ankle fractures were identified. Patients with a different principle diagnosis were excluded. Net revenue, total cost of inpatient care, and direct margin for each patient's acute inpatient hospital course were recorded.

Main outcome measurement: Direct margins, costs.

Results: Per patient, the overall mean net revenue was $39,813, overall mean cost of inpatient care was $21,231, and overall mean direct margin (profitability) was $18,582. Mean direct variable expense was $14,898 per patient, and mean direct fixed expense was $6333 per patient. Factors most influencing cost included length of stay, supplies, and operating room use. Of 1228 patients, 46 (3.7%) had a negative direct margin (net loss to hospital). The most profitable diagnosis was pelvic fracture (mean direct margin, $21,767).

Conclusions: The state-regulated reimbursement system allows analysis of hospital profitability in the context of a normalized revenue stream that should approximate the overall fiscal realities of other states. Providing orthopaedic trauma care can be economically feasible and profitable for a hospital.

Level of evidence: Economic Level IV. See Instructions for Authors for a complete description of levels of evidence.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Clinical Coding
  • Cohort Studies
  • Cost-Benefit Analysis / statistics & numerical data
  • Costs and Cost Analysis
  • Fractures, Bone / economics*
  • Fractures, Bone / epidemiology
  • Fractures, Bone / surgery
  • Hospital Costs / statistics & numerical data*
  • Humans
  • Insurance, Health, Reimbursement / economics*
  • Length of Stay / statistics & numerical data
  • Maryland / epidemiology
  • Orthopedics / economics*
  • Outcome Assessment, Health Care
  • Retrospective Studies
  • Trauma Centers / economics*
  • Wounds and Injuries*