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Is Treating Oral and Maxillofacial Trauma Profitable? An Analysis of Hospital and Surgeon Reimbursement at an Academic Medical Center.

Abstract During the past 2 decades, there has been a marked decrease in the willingness of community-based oral and maxillofacial surgeons to participate in trauma call. Although many factors can influence the decision not to take trauma call, 1 primary disincentive is the perception that managing facial trauma might be profitable for the hospital, but not profitable for the surgeon. The purpose of this study was to compare the profitability of facial trauma management for the hospital and the surgeon at the Virginia Commonwealth University (VCU) Medical Center (Richmond, VA).
PMID
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Authors

Mayor MeshTerms
Keywords
Journal Title journal of oral and maxillofacial surgery : official journal of the american association of oral and maxillofacial surgeons
Publication Year Start




PMID- 28341451
OWN - NLM
STAT- MEDLINE
DA  - 20170325
DCOM- 20170419
LR  - 20170419
IS  - 1531-5053 (Electronic)
IS  - 0278-2391 (Linking)
VI  - 75
IP  - 2
DP  - 2017 Feb
TI  - Is Treating Oral and Maxillofacial Trauma Profitable? An Analysis of Hospital and
      Surgeon Reimbursement at an Academic Medical Center.
PG  - 357-361
LID - S0278-2391(16)30909-0 [pii]
LID - 10.1016/j.joms.2016.09.047 [doi]
AB  - PURPOSE: During the past 2 decades, there has been a marked decrease in the
      willingness of community-based oral and maxillofacial surgeons to participate in 
      trauma call. Although many factors can influence the decision not to take trauma 
      call, 1 primary disincentive is the perception that managing facial trauma might 
      be profitable for the hospital, but not profitable for the surgeon. The purpose
      of this study was to compare the profitability of facial trauma management for
      the hospital and the surgeon at the Virginia Commonwealth University (VCU)
      Medical Center (Richmond, VA). MATERIALS AND METHODS: In this retrospective
      cohort study, records were collected for patients who were seen for primary
      trauma management by the Department of Oral and Maxillofacial Surgery at VCU
      (VCUOMS) from June 2011 through July 2014. Cost and reimbursement data were
      analyzed for these patients from the VCU Health System (VCUHS) and the VCUOMS.
      For the hospital, actual cost data were provided; for the surgeon, cost was
      calculated based on an average overhead of 50%. For uniformity, patients were
      excluded if they remained in the hospital for longer than a 23-hour observation
      period. Patients younger than 18 years also were excluded. RESULTS: In total, 169
      patients met the inclusion criteria. There was a statistically relevant
      difference in the percentage of costs recouped and the actual profit. The average
      percentage of costs recouped was 230% for the VCUHS versus 47% for the VCUOMS.
      This amounts to an average profit per case of $3,461 for the hospital versus a
      loss of $1,162 for the surgeon. CONCLUSIONS: The results of this study indicate
      that in the VCU Medical Center, maxillofacial trauma yields a net profit for the 
      hospital and a net loss for the operating surgeon. Although the results are
      limited to outpatient management at 1 academic institution, they suggest that
      hospitals in some settings might be in a position to incentivize surgeons for
      trauma management.
CI  - Copyright (c) 2016 American Association of Oral and Maxillofacial Surgeons.
      Published by Elsevier Inc. All rights reserved.
FAU - DeLuke, Dean M
AU  - DeLuke DM
AD  - Associate Professor and Director of Predoctoral Oral and Maxillofacial Surgery,
      Virginia Commonwealth University School of Dentistry and Virginia Commonwealth
      University Medical Center, Richmond, VA. Electronic address: [email protected]
FAU - Agarwal, Vickas
AU  - Agarwal V
AD  - Student, Virginia Commonwealth University School of Dentistry, Richmond, VA.
FAU - Holleman, Trevor
AU  - Holleman T
AD  - Resident, Department of Oral and Maxillofacial Surgery, Virginia Commonwealth
      University Medical Center, Richmond, VA.
FAU - Carrico, Caroline K
AU  - Carrico CK
AD  - Assistant Professor, Virginia Commonwealth University School of Dentistry,
      Richmond, VA.
FAU - Laskin, Daniel M
AU  - Laskin DM
AD  - Adjunct Clinical Professor and Chairman Emeritus, Virginia Commonwealth
      University School of Dentistry and Virginia Commonwealth University Medical
      Center, Richmond, VA.
LA  - eng
PT  - Journal Article
DEP - 20161006
PL  - United States
TA  - J Oral Maxillofac Surg
JT  - Journal of oral and maxillofacial surgery : official journal of the American
      Association of Oral and Maxillofacial Surgeons
JID - 8206428
SB  - AIM
SB  - D
SB  - IM
MH  - Academic Medical Centers/economics/statistics & numerical data
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Hospital Costs
MH  - Humans
MH  - Maxillofacial Injuries/*economics/surgery
MH  - Middle Aged
MH  - Mouth/*injuries
MH  - Reimbursement Mechanisms/economics/statistics & numerical data
MH  - Retrospective Studies
MH  - Surgery, Oral/*economics/statistics & numerical data
MH  - Virginia
MH  - Young Adult
EDAT- 2017/03/28 06:00
MHDA- 2017/04/20 06:00
CRDT- 2017/03/26 06:00
PHST- 2016/07/14 [received]
PHST- 2016/09/22 [revised]
PHST- 2016/09/25 [accepted]
AID - S0278-2391(16)30909-0 [pii]
AID - 10.1016/j.joms.2016.09.047 [doi]
PST - ppublish
SO  - J Oral Maxillofac Surg. 2017 Feb;75(2):357-361. doi: 10.1016/j.joms.2016.09.047. 
      Epub 2016 Oct 6.

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