Trauma Care Questions

1. What obligations does the UCMC feel to engage community health needs in the expansion of the hospitals? What steps does the UCMC currently take to address community needs, and how do these steps align with UCMC's mission to deliver the best care to the most people possible? As the only academic medical center in the underserved South Side, the University of Chicago Medical Center has a number of health care responsibilities. The most pressing and all-encompassing is to provide services that are scarce or unavailable at the same level at other area hospitals. This includes our worldrenowned complex cancer care and a level 1 trauma center for children, as well as services and care for inflammatory bowel disease, neurological conditions, organ transplants and heart device implantations. It also includes rare emergent services that nearby communities need, such as our burn unit, one of only three in the Chicago area, and our intensive care units, with special emphasis on the pediatric and neonatal ICUs. Another one of the Medical Centers responsibilities is to take care of patients who are sent from other hospitals that dont have the level of expertise and experience that our medical staff possesses. The Medical Center treats the second-highest number of sexual assault and domestic violence victims. We are training our nurses to become a state certified sexual assault treatment center. We also are in talks with local anti-violence community groups to see how we can better partner with existing programs to end violence. Through the research and community clinical care efforts of the Medical Center, members of our faculty and the Urban Health Initiative, the Medical Center is also addressing many of the health disparities in our surrounding neighborhoods, such as diabetes, obesity, breast cancer, HIV infection rates and basic lack of access to medicine. In fact, UCMC spends more than $200 million every year on services and programs that benefit the community, including providing charity care, uncompensated care and funding of education and research. At the same time, the Medical Center is working proactively to create a coordinated network of care that spans the South Side and can offer care to patients in convenient and well-matched settings. This includes making University of Chicago physicians available at settings throughout the community. The long-term community commitment also includes training the future physicians and conducting research of the communitys needs and resources as a first step in improving access and the quality of care. The Medical Center is also investing in the community by building a new state-of-the-art hospital pavilion. South Side residents deserve to have a modern hospital providing the most advanced health care with the best doctors. Our current facility was built in 1983 and needs to be updated. Other academic medical centers in the city also have recently launched major building projects to update their facilities. Our plan is to be here for the community for generations to come, so we need to remain at the top of our field and to continue to grow. In order to do that, UCMC must position itself to be financially stable by investing in its future. If UCMC fails to stay competitive, the South Side risks another medical center closure, which happened in June 2009 when Michael Reese Hospital. Michael Reese Hospital closed its level 1 trauma center in 1989 after facing escalating financial challenges as operating expenses increased amid aging facilities. The University of Chicagos New Hospital Pavilion project has become an economic engine fueling minority- and women-owned businesses in the Chicago area. The Medical Center has paid close to $98 million in contracts to 94 minority- and women-owned business enterprises, such as material suppliers, construction contractors and professional services firms. That number represents more than 48 percent of the $206.7 million paid to date on the project.

2. What role could trauma care and violence prevention research play in fulfilling the UCMCs commitment to being at the forefront of medicine? Based on the data, we now know that faster access to trauma care on the South Side will have, at most, an extremely limited impact on trauma survival, but there is good reason to think that significant research and widespread implementation of violence prevention could make a real difference in saving lives. Preventing a traumatic injury, such as a gunshot, provides a broader benefit than improving trauma care by four or five minutes in transit. We are looking for ways that we can make a meaningful impact in the community and violence prevention is one of several we are investigating. The University of Chicago is researching ways to decrease violence in the community. The Crime Lab in the School of Social Services Administration supports community-based programs to determine best practices for changing risky behaviors in young people. The Medical Center Emergency Room, which treats the second-highest number of sexual assault and domestic violence victims in the city, is partnering with the state to train nurses to become certified Sexual Assault Nurse Examiners. The Medical Center also is working with community groups that interrupt gun violence. Trauma is just one aspect of critical care and should not be viewed in isolation. As part of a broader conversation involving health care providers throughout the region, UCMC would be interested in examining the needs for and current distribution of emergency health care. 3. What can the UCMC draw from the successful models of peer institutions like Penn Medicine and Johns Hopkins that have been able to sustainably fund quality trauma care? Both Johns Hopkins and Penn Medicine are much larger than the University of Chicago Medical Center and each of them is the dominant medical center in their home cities. Having said that, we are currently studying how Johns Hopkins implements its anti-violence programs. 4. As a non-profit hospital, what state and federal grants and/or tax breaks does the UCMC receive, and what services does that money go towards? How do those funds offset the cost of providing uninsured care? There is no reliable study of the value of tax breaks for not-for-profit hospitals. We do know that UCMCs contributions to community benefit, the various forms of providing uncompensated care and services for the poor, are many times the value of those tax breaks and significantly above the average for academic medical centers nationwide. For the latest fiscal year ending June 2011, the Medical Center provided more than $200 million in community benefit, which represents about 18 percent of the hospitals operating revenue. Those funds support a range of services and programs, from running clinics on the South Side to conducting research to immunizing children. More than $17 million goes to the cost of providing medical care for those who cant afford it. The Medical Center absorbs an additional $12.6 million from patients who cannot pay and $76.6 million from government reimbursements for Medicare and Medicaid that dont cover the cost of treatment. 5. How much would a trauma center cost, and how would establishing one affect resources and other departments in the UCMC? What studies and/or evidence supports these predictions? How is the UCMC working to ensure transparency and visibility during this investigation? The Medical Center does not know how much a trauma center would cost. Because there has been no evidence that a trauma center at the University of Chicago is critical to patient outcomes, the Medical Center does not see a need to spend critical resources on such a study.