An Indiana State Trauma System Questions to Consider…

1. An Indiana State Trauma SystemQuestions to Consider… Do We Want One? Do We Need One? How Much Do They Cost?

2. A Trauma System… Do We Want One? http://www.cdc.gov/injury/wisqars/fatal_injury_reports.html

3. A Trauma System… Do We Want One? • Let’s say Indiana legislators appropriate $20 million for a state trauma system. This costs each taxpayer close to $7 per year (aboutwhat you pay for a couple of lattes at Starbucks). • And, let’s assume that after things are up and running the mortality rate comes down to what it is in Washington State (59 → 57/100,000). • So, at a cost of about $870,000/life, our brand new Indiana state trauma system would end up saving about 140 lives per year (that’s$20 million spent on0.002% of the population). • Now, reductions in mortality as much as 20% have been reported. That could bring mortality down to 48/100,000, with now 760 lives saved every year (but, still a lot of money for a very small segment of the state’s population) . • Leading cause of death in IN is heart disease with a mortality in 2010 of 210/100,000. If $20 million goes instead into health care programs that reduce cardiac deaths by 20%, then 2,500 lives can besaved each year.

4. A Trauma System… Do We Need One? Before you say, NO, there is one statistic we must consider further: “Years of Potential Life Lost (YPLL)” • YPLL from trauma deaths in IN translates into $2,761,230,416 in lost wages and $938 million in lost tax revenue to the state. • If there is a 20% reduction in mortality with a trauma system, then a $20 million investment returns $30 million as tax revenue in one year alone. (That’s a 50% annualized ROI).

5. The Rural Triangle Of Death

6. A Trauma System… How Much Do They Cost? (Expensive, but doable… say, $3 million) • Trauma Designation • Designates hospitals to provide trauma services • Develops trauma clinical care guidelines and protocols • Trauma Registry • Collects, analyzes and reports data on seriously injured patients • Trauma System Evaluation and QI • Provides evaluations of clinical care, system performance and patient outcomes at local, regional and statewide levels • Emergency Management Services Information Systems • Provides pre-hospital data reporting and analysis • Trauma Fund • Provide financial support to hospital, physician, prehospital, and rehabilitation services (We already have this… NHTSA and CDC grants) (Important… perhaps $750,000) (Up to DHS) (The big ticket line item…$40-60 million) Throw in $750,000 for a Director, EMS Section Manager, Research and Data Analysis Section Manager, Rural Health Systems Section Manager, and an EMS Section Supervisor

7. A Trauma System… How Do We Pay For One? Health Resources and Services Administration (HRSA) document Model Trauma System Planning and Evaluation published by the U.S. Department of Health and Human Services Program Support Center, 2006 “Trauma systems need sufficient funding to implement a statewide and regional system of care—one focused on each component of care from prevention through acute care and rehabilitation, including all-hazards preparedness.” Some State trauma programs can be supported by the following: • Motor vehicle fees, fines, and penalties • Court fees, fines, and penalties (not motor vehicle related) • 9-1-1 system surcharges • Intoxication offense fees • Controlled substance act or weapons violation fees • Taxes on sales of tobacco • Tribal gaming • State and local taxes($55 million = $20/year/taxpayer)