The efficacy of a two-tiered trauma activation system at a level I trauma center.

Background: By using current American College of Surgeons trauma center triage criteria, 52% of patients transported to our level I trauma center are discharged home from the emergency department (ED). Because the majority of our trauma transports were based solely on mechanism of injury, we instituted, in 1990, a two-tiered trauma team activation system. Patients are triaged into major and minor trauma alert categories based on prehospital provider information.

Trends in charges and payments for nonhospitalized emergency department pediatric visits, 1996-2003.

Objectives: To compare charges and payments for outpatient pediatric emergency visits across payer groups to provide information on reimbursement trends.

Methods: Total charges and payments for emergency department (ED) visits Medicaid/State Children's Health Insurance Program (SCHIP), privately insured, and uninsured pediatric patients from 1996 to 2003 using data from the Medical Expenditure Panel Survey. Average charges per visit and average payments per visit were also tracked, using regression analysis to adjust for changes in patient characteristics.