Payor mix of trauma patients at a rural-metropolitan regional trauma center: a three-year experience.

The development of a statewide trauma system will depend on designation of community hospitals as trauma centers. The financial impact of such designation will be a prime concern. The payor mix of trauma patients will be one of the deciding factors as to whether hospitals will agree to accept designation. A three-year review of payor class on discharge for 2,605 trauma and 55,041 nontrauma admissions to a nonuniversity teaching hospital is presented. Sixty-four percent of all trauma admissions had third-party payor insurance coverage, compared with 72% of all nontrauma admissions (P less than .00001). Twenty-seven percent of trauma admissions were for penetrating injury. Sixty-eight percent of patients admitted for blunt trauma had third-party coverage, while 50% of those admitted for penetrating trauma had third-party coverage. Total commercial insurance coverage was higher for trauma patients than for nontrauma admissions. The payor class mix for trauma patients presented may be representative of similar institutions in a similar geographic setting and may offer assistance to hospitals considering the financial impact of trauma center designation.