Make us your home page

Today’s top headlines delivered to you daily.

(View our Privacy Policy)

Times investigation: Insult to injury

How we reported on Florida trauma fees

To examine how Florida trauma centers bill their patients, the Tampa Bay Times relied on billing data collected by state health officials from hospitals across the state.

The databases, maintained by the Agency for Health Care Administration, include diagnosis, treatment and hospital charge information for every patient seen in an emergency room or admitted to a Florida hospital.

The database does not identify patients by name or address.

The Times analyzed more than seven years of data going back as far as 2006, the first year the state required hospitals to break out fees for trauma response.

To conduct its analysis, the Times sought additional information that is not contained in the state databases.

For example, the state data does not explicitly identify trauma patients. To identify them, researchers typically use the medical diagnostic codes recorded in the data. The Times consulted with experts and used a widely accepted formula that flags trauma patients based on injuries.

Among the experts was Etienne Pracht, a University of South Florida health care economist who is one of the state's leading experts in analyzing injury severity and trauma trends using the state's data.

The Times focused on patients with diagnostic codes widely considered trauma cases, including brain and spinal cord injuries, burns, broken skulls and complex limb fractures. We further limited our analysis to only those patients flagged in the data as emergencies or trauma cases.

In addition, the Times included any patient who was charged a trauma response fee.

To interpret diagnosis and treatment codes recorded in the data, the Times relied on information from Alkaline Software Inc., a company that publishes medical databases. It provides free information about the codes online at

Finally, the Times relied on USF researchers, including Pracht, to provide a severity rating for each individual patient for the most recent year and a half of data. Pracht's methodology, widely used by researchers, allowed the Times to compare trauma centers based on the level of injuries sustained by its patients.

Ultimately, the Times analysis focused on 306,525 patients who met the criteria for trauma and were seen at trauma centers from 2006 to June 2013, the most recent data available.

The analysis included patients from 26 hospitals that operated trauma centers in that time. It did not include the two children's hospitals receiving trauma patients. One trauma center, Orange Park Medical Center, only operated from November 2011 to February 2013.

The Times analysis likely underestimates the number of patients who were treated at a trauma center and then released the same day. That's because one of the two databases state officials use to track hospital charges has limitations.

The database — for emergency department patients who don't get admitted to the hospital — does not track the status of patients upon arrival, which was needed in our methodology to identify true trauma patients.

Letitia Stein And Alexandra Zayas, Times staff writers


How we reported on Florida trauma fees 03/07/14 [Last modified: Friday, March 7, 2014 6:27pm]
Photo reprints | Article reprints

© 2017 Tampa Bay Times


Join the discussion: Click to view comments, add yours

  1. Early morning fire breaks out at Clearwater Beach motel


    Clearwater Fire and Rescue is at the scene of an early morning fire that broke out at a motel on Clearwater Beach.

  2. Florida education news: Free speech, Schools of Hope, student voices and more


    FREE SPEECH: The University of Florida reluctantly hosts white nationalist activist Richard Spencer for a rally officials are encouraging students to ignore. Campus president Kent Fuchs, who tried to prevent the activity from taking place, Troopers prepare for Richard Spencer's speech at the University of Florida. Gov. Rick Scott has declared a State of Emergency for Alachua County ahead of the event.

  3. How old is too old to go trick-or-treating on Halloween?

    Human Interest

    Brandi Eatman guesses the boy was at least 15 years old.

     Costume accessories at House of Make Believe at 1055 N Hercules Ave. in Clearwater. [CHERIE DIEZ | Times]
  4. Report: West Pasco channel dredges could cost up to $13.5 million

    Local Government

    NEW PORT RICHEY — The cost of dredging a dozen coastal canals serving seven west Pasco communities could reach nearly $13.5 million, according to a consultant's report.

    WILL VRAGOVIC   |   Times
 A consultant recommends that Pasco County consider a dozen canal dredging projects in west Pasco's coastal communities at a cost that could reach nearly $13.5 million. [WILL VRAGOVIC, Times 2011]
  5. Records show Hernando Beach fire chiefs defrauded taxpayers of thousands

    Local Government

    BROOKSVILLE — The three former chiefs of the defunct Hernando Beach Volunteer Fire Department, arrested in September, are collectively accused of defrauding the taxpayers of Hernando Beach, Aripeka and Forest Glenn of tens of thousands of dollars.

    David Freda, a former Hernando Beach fire chief, has been charged with organized fraud. He recently was fired as Brooksville’s fire chief.