ArticleAnnals of surgery open : perspectives of surgical history, education, and clinical approaches2026
Trauma Activation Fee Variations Across Hospital Ownership, Safety-net, American College of Surgeons Committee-on-Trauma Verification, and State Designation Status.
Article in Annals of surgery open : perspectives of surgical history, education, and clinical approaches, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
1 citing paper in PubMed.
- State Trauma Center Designation Criteria and Expansion of For-Profit vs Nonprofit Trauma Centers.JAMA network open · 2026Article
Corrections and comments
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Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Introduction: Trauma activation fees (TAF) are intended to offset the costs of trauma readiness yet remain unregulated. Prior studies have explored TAF variations across American College of Surgeons Committee on Trauma (ACS-COT)-verified centers, which represent a minority of US trauma centers. We aimed to characterize TAF variations across all US trauma centers, accounting for previously underexplored characteristics that may be associated with TAFs. Methods: This cross-sectional study evaluated all level I-III designated US trauma centers and their TAFs. We delineated each trauma center's hospital [hospital ownership (for-profit or nonprofit), designation level (I/II or III), ACS-COT verification, and safety-net hospital status] and county-level characteristics (per capita income, Area Deprivation Index, years-of-potential-life-lost from fatal injury). Multivariable lasso regression evaluated the association between median TAFs and hospital ownership status, with trauma center designation level as an effect modifier. Results: Study cohort comprised 1014 trauma centers [N = 166 (16.4%) for-profit]. Across all designation levels and ACS-COT verification status, for-profit trauma centers had higher median TAFs compared with nonprofit counterparts. We did not find a statistically significant difference in TAFs over safety-net or ACS-COT-verified status. Multivariable lasso regression did not find a statistically significant association between hospital ownership status and TAFs [β = 4540 (-722 to 9810); Conclusion: Nationwide analysis of over 1000 designated US trauma centers found wide heterogeneity in TAFs and an association between for-profit ownership status and higher TAF among level I and II trauma centers. Whether observed nationwide TAF heterogeneity characteristics warrant evaluating the role of TAF regulation deserves discussion.
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