Trauma center funding bill sent to Governor for approval

State’s trauma system needs life support, USF study finds

Media contact: Anne DeLotto Baier, USF Health Sciences Public Affairs, (813)974-3300 or abaier@hsc.usf.edu

Tampa, FL (May 3, 2005) -- Florida needs more trauma centers strategically linked within the state, according to a University of South Florida assessment of the Florida Trauma System. Florida lawmakers, considering alternative ways to support the overburdened system, have used the USF study as a basis for change.

In the last week of the Legislative session, both the House and Senate passed identical bills to double fines for running red lights, which would raise between $15 and $20 million yearly. The trauma center funding bill has been sent to Gov. Jeb. Bush for approval.

“This is a good first step and departs from the historical approach taken by the government in that it offers a persisting revenue stream for the state’s trauma centers,” said lead investigator Lewis Flint, MD, USF professor of surgery and chief of Tampa General Hospital’s Regional Trauma Center, which served patients from 23 counties and had a net loss of nearly $10 million in 2003.

“We simply don’t have enough trauma centers to take care of Florida’s growing population. Without durable funding, our trauma system cannot continue to do what it does best -- save lives and return recovered trauma victims to productive life.”

Trauma centers must meet specific state requirements for prompt treatment of life-threatening injuries, like severe fractures and multiple internal injuries, and are also required to retain trauma-trained teams of medical specialists around the clock.

Despite establishing an organized trauma system more than 20 years ago, Florida has not provided a stable, recurring source of funding for trauma care. Shortfalls in yearly appropriations have meant hospitals pay a steep price to keep their trauma centers open and transport helicopters flying – often at the expense of other specialty services. In the last two years, hospitals in Florida have threatened to close three trauma centers.

“This is not a long-term solution,” Dr. Flint said. “It ties up the assets of the trauma center hospital and robs its ability to attract staff and compete in the marketplace.” 

Researchers from the USF College of Public Health and the Departments of Surgery at USF and the University of Florida analyzed outcomes of the state’s trauma system as well as costs and financial support of trauma centers. The USF study found that accident victims quickly rushed to a trauma center were more likely to survive than victims coming from locations distant to the trauma center, especially after motor vehicle crashes.

The Florida Department of Health funded the study, which included the following findings:

·        A county’s overall death rate is higher if a trauma center is not present in that county.

·        Additional trauma centers are needed to serve Florida, particularly in the state’s rural panhandle.

·        The state’s 21 trauma centers treated 23,000 patients in 2003. The volume of severely injured patients managed at trauma centers is three times higher than similar trauma cases at non-trauma center hospitals.

·        Overall, the triage rate of severely injured patients sent to trauma centers in Florida is slightly more than 40 percent, up from 38 percent since the study was completed -- but still lower than the national average of 60 percent.  The study authors recommend adding trauma centers in Tallahassee and Bay County, which would raise the triage rate to 50 percent.

·        Trauma centers lose money and need outside funding; the average net loss for a trauma center in Florida is $5 million.  Financial pressures are due to the high level of 24-hour specialty staffing required and to the severity of injuries treated. In addition, uncompensated care and increased malpractice insurance costs have exacerbated the problem.

·        Alternatives to fund trauma care include increasing penalties for motor vehicle violations, driver’s license surcharges or alcohol taxes.

The system of using specially-designed trauma centers was advanced through experiences in the Vietnam War, where it was observed that wounded soldiers immediately transported to a trauma center did better than those treated in the field.

“That observation is still true,” Dr. Flint said. “The further you are from a trauma center, the worse your outcome.”

USF coinvestigators for the trauma study were Barbara Orban, chair and associate professor of the health policy and management; Rodney Durhan, MD, professor of surgery; Jay Wolfson, JD, PhD, professor of health policy and law; Etienne Pracht, assistant professor of health policy and management; and Celeste Kallenborn, RN, MBA, trauma program manager at TGH.

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The University of South Florida Health Sciences Center is comprised of the colleges of Medicine, Nursing and Public Health and united by one mission “to advance collaborative learning and discovery leading to improved health in our community.” USF has major affiliations with the area’s teaching and research hospitals, providing an important diversity of educational experiences. In partnership with its affiliated hospitals, the Health Sciences Center’s research funding jumped 21 percent last year to $145.4 million — more than half of which came from federal sources.