The cost and compensability of trauma patients

Taylor

et al. 2012

BMC Health Serv Res

Self Cite

BackgroundIn order to assist health service planning, understanding factors that influence higher trauma treatment costs is essential. The majority of trauma costing research reports the cost of trauma from the perspective of the receiving hospital. There has been no comprehensive synthesis and little assessment of the drivers of cost variation, such as country, trauma, subgroups and methods. The aim of this review is to provide a synthesis of research reporting the trauma treatment costs and factors associated with higher treatment costs in high income countries.MethodsA systematic search for articles relating to the cost of acute trauma care was performed and included studies reporting injury severity scores (ISS), per patient cost/charge estimates; and costing methods. Cost and charge values were indexed to 2011 cost equivalents and converted to US dollars using purchasing power parities.ResultsA total of twenty-seven studies were reviewed. Eighty-one percent of these studies were conducted in high income countries including USA, Australia, Europe and UK. Studies either reported a cost (74.1%) or charge estimate (25.9%) for the acute treatment of trauma. Across studies, the median per patient cost of acute trauma treatment was $22,448 (IQR: $11,819-$33,701). However, there was variability in costing methods used with 18% of studies providing comprehensive cost methods. Sixty-three percent of studies reported cost or charge items incorporated in their cost analysis and 52% reported items excluded in their analysis. In all publications reviewed, predictors of cost included Injury Severity Score (ISS), surgical intervention, hospital and intensive care, length of stay, polytrauma and age.ConclusionThe acute treatment cost of trauma is higher than other disease groups. Research has been largely conducted in high income countries and variability exists in reporting costing methods as well as the actual costs. Patient populations studied and the cost methods employed are the primary drivers for the treatment costs. Targeted research into the costs of trauma care is required to facilitate informed health service planning.

Section: Resultsmentioning

confidence: 99%

“…In single-payer health systems using episode-funding models, hospitals are reimbursed according to case mix, which may result in underfunding [10-12]. Due to the variability in injury severity, averaging patient costs is problematic and diagnostic-related groups do not adequately represent trauma patient episodes [12].…”

Section: Introductionmentioning

confidence: 99%

The variation of acute treatment costs of trauma in high-income countries

Willenberg

Taylor

et al. 2012

BMC Health Serv Res

Self Cite

“…There is some evidence that episode-based funding results in underfunding of trauma treatment in NSW. 15,16 It is not known if this current funding model adequately describes the paediatric patient episode and results in adequate reimbursement for the treatment costs. This research aimed to describe the costs of acute trauma admissions for children aged Յ15 years in trauma centres and to identify predictors of higher treatment costs and quantify any difference between the total actual cost and the total AR-DRG average costs of care.…”

Section: What This Paper Addsmentioning

confidence: 99%

“…The state‐wide average patient costs for each AR‐DRG are then determined and form the basis of each hospital's funding allocation. There is some evidence that episode‐based funding results in underfunding of trauma treatment in NSW . It is not known if this current funding model adequately describes the paediatric patient episode and results in adequate reimbursement for the treatment costs.…”

mentioning

confidence: 99%

Acute costs and predictors of higher treatment costs for major paediatric trauma in New South Wales, Australia

Mitchell

J Paediatrics Child Health

Holland

et al. 2013

Self Cite

“…4,5 The high rate of hospital presentation for morbidity results in high costs to the health care system because of increased lengths of stay and greater complexity of care. 6 In Australia, age-specifi c mortality rates for injury are relatively steady for both men and women from early adulthood through to the late 1960s, but rise rapidly from age 70 years onwards. 7 In 2004 to 2005, those aged 75 years and older accounted for 38% (n ϭ 3701) of all injury deaths in Australia with injury death rates highest for both sexes in this age group.…”

mentioning

confidence: 99%

Identifying Risk and Raising Awareness in Older Person Trauma

Kourouche

Journal of Trauma Nursing

Watson

et al. 2011

Self Cite

W ith the ageing of our population and increasing longevity, the incidence and complexity of trauma in older persons (65 years and older) is increasing. 1 Older persons are at greater risk of injury because of their diminishing faculties including vision, hearing, touch, and reaction times. 2,3 Compared with younger age groups, older persons also have higher mortality and morbidity rates because of increasing frailty ABSTRACT Injury among older persons is well recognized as a growing problem. We reviewed our level-1 trauma center trauma registry fi nding that the most frequent presentations among people aged older than 65 years were due to falls and motor vehicle crashes. We surveyed participants at two of our older person injury awareness seminars to identify risk factors. Participants at our out-reach programme have several injury risk factors including polypharmacy for which our programme content has been tailored. We discuss this in relation to the older person injury-prevention literature. Because implementing our out-reach seminars, older person trauma presentations to our trauma center have decreased slightly. and comorbidities. 4,5 The high rate of hospital presentation for morbidity results in high costs to the health care system because of increased lengths of stay and greater complexity of care. 6 In Australia, age-specifi c mortality rates for injury are relatively steady for both men and women from early adulthood through to the late 1960s, but rise rapidly from age 70 years onwards. 7 In 2004 to 2005, those aged 75 years and older accounted for 38% (n ϭ 3701) of all injury deaths in Australia with injury death rates highest for both sexes in this age group. 7 Age-specifi c injury hospitalization rates follow a similar pattern, although rates among males increase in the teens, peak in the early 20s, then decline until 70 years of age before increasing signifi cantly. 8 Similarly for females, hospitalization rates are relatively steady until around the age of 65 years when, due to mainly to the increasing rate of falls, they escalate signifi cantly. 8 FALLSFalls are the leading cause of injury-related mortality and hospitalized morbidity in older people in most developed countries. 4 In Australia, one in three people aged older than 65 years have at least one fall a year with 30% of these requiring medical attention. 9 Falls from standing are the only injury-related cause of death and hospitalization in which there is a signifi cantly greater number of females, compared to males. 9 ROAD TRAUMARoad trauma is also a signifi cant cause of injury-related mortality and hospitalized morbidity among older people. This is especially evident for pedestrians, with persons older than 60 years accounting for more than 30% of all pedestrian fatalities in Australia. 10 Fatality rates in older drivers are nearly double that of younger drivers. Those aged older than 85 years have nearly four times risk of being involved in a fatal crash when driving than their younger counterparts. 11 Furthermore, people aged older t...