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Financial Stability of Level I Trauma Centers Within Safety-Net Hospitals

Overview of attention for article published in Journal of the American College of Surgeons, August 2018
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About this Attention Score

  • In the top 5% of all research outputs scored by Altmetric
  • High Attention Score compared to outputs of the same age (94th percentile)
  • Good Attention Score compared to outputs of the same age and source (72nd percentile)

Mentioned by

news
2 news outlets
twitter
42 tweeters
facebook
1 Facebook page
wikipedia
1 Wikipedia page

Readers on

mendeley
4 Mendeley
Title
Financial Stability of Level I Trauma Centers Within Safety-Net Hospitals
Published in
Journal of the American College of Surgeons, August 2018
DOI 10.1016/j.jamcollsurg.2018.03.043
Pubmed ID
Authors

Lisa M. Knowlton, Arden M. Morris, Lakshika Tennakoon, David A. Spain, Kristan L. Staudenmayer

Abstract

Level I trauma centers often exist within Safety-Net Hospitals (SNHs), facilities servicing high proportions of low-income and uninsured patients. Given the current healthcare funding environment, trauma centers within SNHs may be at particular risk. Using California as a model, we hypothesized that SNHs with trauma centers vary in terms of financial stability. A retrospective cohort study using data from publically-available financial disclosure reports from California's Office of Statewide Health Planning and Development. Safety-net hospitals were identified from the California Association of Public Hospitals and Health Systems. The primary outcome metric for financial performance was operating margin. California hospitals with Level I Trauma Centers were analyzed (11 SNH sites, 2 non SNH). SNHs did not behave uniformly, and were clustered into county owned SNHs (36%, n=4) and non-profit owned SNHs (64%, n=7). Mean operating margins for county SNHs, non-profit SNHs and non SNHs were -16.5%, 8.4% and 9.5% respectively (p<0.001). From 2010 to 2015, operating margins improved for all hospitals, partly due to increases in the percent of insured patients and changes in payer mix. Non-profit SNHs had a payer mix similar to non SNHs, whereas county SNHs had the highest proportions of MediCal (California Medicaid) (45% vs. 36% vs. 12%, p<0.001) and uninsured patients (17% vs. 5% vs. 0%, p<0.001) compared to non-profit SNHs and non SNHs respectively. The majority (85%) of Level I Trauma Centers are within SNHs, whose financial stability is highly variable. A group of SNHs rely upon on infusions of government funds and are therefore susceptible to changes in policy. These findings suggest deliberate funding efforts are critical to protect the health of the U.S. academic trauma system.

Twitter Demographics

The data shown below were collected from the profiles of 42 tweeters who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 4 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 4 100%

Demographic breakdown

Readers by professional status Count As %
Other 3 75%
Student > Ph. D. Student 1 25%
Readers by discipline Count As %
Medicine and Dentistry 2 50%
Social Sciences 1 25%
Unspecified 1 25%

Attention Score in Context

This research output has an Altmetric Attention Score of 49. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 03 November 2018.
All research outputs
#284,579
of 12,122,790 outputs
Outputs from Journal of the American College of Surgeons
#158
of 2,462 outputs
Outputs of similar age
#13,860
of 258,576 outputs
Outputs of similar age from Journal of the American College of Surgeons
#10
of 37 outputs
Altmetric has tracked 12,122,790 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 97th percentile: it's in the top 5% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 2,462 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 11.9. This one has done particularly well, scoring higher than 93% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 258,576 tracked outputs that were published within six weeks on either side of this one in any source. This one has done particularly well, scoring higher than 94% of its contemporaries.
We're also able to compare this research output to 37 others from the same source and published within six weeks on either side of this one. This one has gotten more attention than average, scoring higher than 72% of its contemporaries.