Treatment of polytrauma patients requires a large number of well trained staff and expensive medical equipment. The high medical standard in polytrauma care resulted in a reduction of a 40% lethality in the 70's to 10 to 15% today. The changes in german health systems (GSG) cut down the financial resources and call for careful evaluation of costs in trauma centers. Our analysis of the costs of 1 multiple injured patient in 1996 showed, that the reimbursements of hospital charges ended in a deficit of DM 30,000,-. Our department treats approximately 100 polytraumas a year which implies a budget deficit of 3 million DM per year. Today the aim of trauma centers is the maintenance of a high surgical standard in trauma care together with adequate reimbursement of hospital expenses. Trauma care and life saving interventions must not be shortened by financial restrictions. The trauma surgeon has to take care for his multiple injured patients and balanced financial reimbursements as well.