The cost of uncompensated trauma care is a significant barrier to trauma system development. Trauma center designation may burden an institution with an unprofitable mix of underinsured, severely injured patients. Concerns about inadequate reimbursement may motivate interhospital transfers on the basis of insurance status rather than medical necessity, potentially undermining the effectiveness of the system. We set out to explore whether this phenomenon exists in a mature trauma system.
Division of General and Trauma Surgery, Department of Surgery, Harborview Medical Center, University of Washington, 325 Ninth Avenue, Seattle, WA 98104-2499, USA. anathans@u.washington.edu
