We all no doubt have some basic awareness of the role of an emergency room. But what do we know about a “trauma center?” The name itself confers some level of significance: trauma is really bad stuff, and a “center” has to have a lot more infrastructure and capability than a mere room. So, what’s in a name?
As a practical matter, an emergency rooms provide immediate access to care for complaints of illness, injury, and many sorts of trauma. Emergency departments are critical functions of hospitals. Smaller, rural hospitals, might be staffed by only two, three, of four doctors, who rotate shifts and rarely have the benefit of double coverage. So when someone is severely injured, such from a car crash, knife wound, gunshot wound, or being mauled by a bear, the level of care required may exceed that available in the local emergency room.
Enter the trauma center. “Trauma centers” are designated by local governments, often along standards defined by the American College of Surgeons (ACS). The ACS can separately verify the trauma center as a level I, II, III, and IV, based on resources there available. Broadly speaking, you can think of the trauma center offering life saving care.
Trauma centers are also big business for hospital systems. Trauma team activation fees can bring in tens of thousands of dollars per incident. This is allowed because trauma centers are exempt from many laws intended to limit excessive spending by hospitals. But, there is little oversight in the hospital’s decision to activate a trauma team.
These lucrative charges – and reimbursements by private insurers – have led to a significant growth of trauma centers in different parts of the country. And this has, in turn, led to the number of trauma cases doubling in places like Florida over a ten year period. Significant for patients, the fees charged for trauma team activation vary tremendously by hospital. In Idaho, for example, one system charges $2,574, while the same service costs $29,312 at an HCA Healthcare facility.
What’s in a name? Apparently a lot of money.
