Coughlin et al., “Tracking Spending, Mortality, and Readmissions as the Number of Comprehensive Trauma Centers Increases” (Houston: Rice University’s Baker Institute for Public Policy, February 26, 2024), https://doi.org/10.25613/SZF1-DX70.
Media stories have raised concerns about Florida’s expansion of advanced trauma centers, where newly designated centers began charging high trauma activation fees for relatively minor injuries. Texas experienced similar expansion of Level II trauma centers between 2011 and 2019. To study the association between trauma center upgrades and patient outcomes, we examined commercial claims from a large insurer in Texas to track changes in spending, mortality, and readmissions of trauma patients. In a few cases newly upgraded trauma centers had higher spending relative to facilities that were operating in 2011, and many more had lower mean spending. Nevertheless, the handful of newly upgraded trauma centers with higher spending exceeded mean spending at existing centers substantially. We found little difference in readmissions or mortality. Given that new Level II trauma centers in Texas were located in areas lacking adequate access to advanced trauma care, the Texas expansion plausibly improved patient welfare.
This research was supported by a 2019 grant from Health Care Service Corporation’s Affordability Cures Initiative. We are grateful for helpful comments from Maggie Shi.
The Author (MC) has research support from Health Care Service Corporation. The author (MS) has research support from Health Care Service Corporation, National Academy of State Health Policy and Arnold Ventures. The author (SM) reports that she was an employee of Blue Cross Blue Shield of Texas. The author (JS) has research support from Health Care Service Corporation. The author(VH) of this publication has research support from Health Care Service Corporation, National Academy of State Health Policy and Arnold Ventures and also holds stock in IBM; serves on a community advisory board for Blue Cross Blue Shield of Texas, Houston Business Coalition on Health Care, Texas Employers for Affordable Health Care and BCBS Alliance; serves on the Board of Directors of Community Health Choice, and received an honorarium from Blue Cross Blue Shield of Texas; and has given expert testimony for a Georgia Certificate of Need hearing. VH is a member of the National Academy of Medicine Membership committee and has received support for attending annual meetings.
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