Article Figures & Data
- Figure 1
Texas management of uncompensated care since 2010. After the enactment of the Affordable Care Act, Texas opted for the 1115 Medicaid waiver and started the Driver Responsibility Program (DRP). The DRP was the primary source of state revenue for the Designated Trauma Facility and Emergency Medical Services Account (5111). Due to insufficient revenue, additional revenue streams were incorporated into the DRP in 2015. The DRP was later repealed in September 2019. As of 2020, no programs have been identified as revenue stream replacements for Account 5111.
- Figure 2
Number of trauma centers included and excluded in analysis of variation between trauma service areas (TSAs). TSA-E, Dallas-Fort Worth area; TSA-O, Austin area; TSA-Q, Houston area.
- Figure 3
Costs and compensation for providing uncompensated care (UC) in millions of US dollars (USD). Costs of providing UC increase with trauma designation from level III to level II (p=0.01) and level I (p<0.01). Current average funding per center is less than 50% of costs for all center levels examined in Texas.
- Figure 4
Payments received for the uncompensated care of trauma patients at level I trauma centers in Dallas-Fort Worth (TSA-E), Austin (TSA-O), and Houston (TSA-Q). Trend line shows total monies acquired by state revenue streams for the compensation of uncompensated trauma care (Account 5111). Data are reported in millions of dollars (USD) for fiscal years 2013 through 2017. Dispersal reports for 2014 were not available. *P<0.05. TSA, trauma service area; USD, US dollar.
- Table 1
Designated trauma centers by service area and population
Number of designated centers* Total population
(millions)Density
Level I and II per million personsLevel I Level II Level III Total TSA-E
DFW Metro Area6 (33.3%) 7 (28.0%) 12 (21.8%) 25 (25.5%) 7.7 1.7 TSA-O
Austin Metro Area2 (11.1%) 3 (12.0%) 1 (1.8%) 6 (6.1%) 2.2 2.3 TSA-Q
Houston Metro Area3 (16.7%) 3 (12.0%) 9 (16.4%) 15 (15.3%) 6.2 1.0 *Does not include centers actively pursuing trauma designation.
DFW, Dallas-Fort Worth; TSA, trauma service area.
- Table 2
Annual costs of providing uncompensated care relative to compensation received through trauma add-on
TSA-E
DFW Metro AreaTSA-O
Austin Metro AreaTSA-Q
Houston Metro Areap-P value Care costs
Average UC
(millions USD)Level I 11.7±4.8 12.4±1.7 31.5±3.9 <0.01 Level II 2.0±2.2 1.9±1.2 0.7±0.4 0.09 Level III 1.3±2.8 0.1±0.05 1.7±1.9 <0.01 Compensation
Average payments
(millions USD)Level I 4.4±0.3 2.7±0.9 11.9±7.8 0.03 Level II 0.8±1.5 0.3±0.2 0.3±0.2 0.29 Level III 0.1±0.09 0.04±0.02 0.6±0.7 <0.01 P value <0.01 <0.01 <0.01 Statistical signifigance was defined as p<0.05 and is displayed in bold.
DFW, Dallas-Fort Worth; TSA, trauma service area; UC, uncompensated care; USD, US dollar.
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