Article Figures & Data
- Table 1
Patientcharacteristics and clinical course
All injuries
(n=63)Orthopedic injury
(n=18)Facial injury
(n=30)Cranial injury
(n=15)P values Patient demographics Age (years) 40.19±13.29 41.83±15.52 40.73±12.56 37.13±12.21 0.69 Male, n (%) 42 (66.7) 12 (66.7) 23 (76.7) 7 (46.7) 0.14 Out-of-town visitor, n (%) 2 (3.2) 0 (0.0) 1 (3.3) 1 (6.7) 0.56 Injury context Motor vehicle involvement, n (%) 16 (25.4) 7 (38.9) 4 (13.3) 5 (33.3) 0.11 Helmet use, n (%) 2 (3.2) 2 (11.1) 0 (0.0) 0 (0.0) 0.08 Any intoxication, n (%)* 37 (58.7) 6 (33.3) 23 (76.7) 8 (53.3) 0.01 Positive BAL, n (%)† 34 (54.0) 5 (27.8) 21 (70.0) 8 (53.3) 0.02 Positive urine toxicology, n (%) 11 (17.5) 2 (11.1) 9 (30.0) 0 (0.0) 0.03 Clinical course BIBA, n (%)‡ 50 (79.4) 14 (77.8) 24 (80.0) 12 (80.0) 0.98 Surgery, n (%) 18 (28.6) 5 (27.8) 11 (36.7) 2 (13.3) 0.20 Length of stay (days) 3.90±8.72 6.61±14.56 2.27±2.69 3.93±7.03 0.18 P-values <0.05 bolded.
*Intoxication defined as defined by clinical evaluation, positive BAL or urine toxicology.
†BAL >11 mmol/L.
‡Patient brought in by ambulance (BIBA).
BAL, blood alcohol level.
- Table 2
Injuries, radioimaging and subspecialty consultations
All injuries
(n=63)Orthopedic
(n=18)Facial
(n=30)Cranial
(n=15)P values Injuries ISS 8.79±4.63 7.67±4.06 8.77±3.40 10.20±6.86 0.40 Concussion, n (%) 7 (11.1) 0 (0.0) 1 (3.3) 6 (40.0) <0.001 Intracranial bleed, n (%)* 7 (11.1) 0 (0.0) 0 (0.0) 7 (46.7) <0.001 TBI, n (%) 2 (3.2) 0 (0.0) 0 (0.0) 2 (13.3) 0.04 Any fracture, n (%) 38 (60.3) 12 (66.7) 23 (76.7) 3 (20.0) 0.001 Lower extremity fracture 6 (9.5) 6 (33.3) 0 (0.0) 0 (0.0) <0.001 Upper extremity fracture 4 (6.3) 3 (16.7) 1 (3.3) 0 (0.0) 0.10 Facial fracture 27 (42.9) 1 (5.6) 23 (76.7) 3 (20.0) <0.001 Spine or rib fracture 2 (3.2) 2 (11.1) 0 (0.0) 0 (0.0) 0.08 Radioimaging Any X-ray 38 (6.3) 16 (88.9) 15 (50.0) 7 (46.7) 0.01 Any non-contrast CT 61 (96.8) 18 (100.0) 30 (100.0) 13 (86.7) 0.04 Any contrast CT 10 (15.9) 2 (11.1) 3 (10.0) 5 (33.3) 0.12 Any MRI 2 (3.2) 1 (5.6) 0 (0.0) 1 (6.7) 0.39 Subspecialty consultation Total number of consults 1.63±0.97 1.67±1.19 1.57±0.82 1.73±1.03 0.90 Trauma, n (%) 47 (74.6) 13 (72.2) 22 (73.3) 12 (80.0) 0.86 Orthopedic trauma, n (%) 8 (12.7) 8 (44.4) 0 (0.0) 0 (0.0) <0.001 Otolaryngology, n (%) 21 (33.3) 1 (5.6) 15 (50.0) 5 (33.3) 0.007 Ophthalmology, n (%) 18 (28.6) 2 (11.1) 14 (46.7) 2 (13.3) 0.01 Neurosurgery, n (%) 14 (22.2) 1 (5.6) 4 (13.3) 9 (60.0) <0.001 Orthopedic hand, n (%) 7 (11.1) 6 (33.3) 1 (3.3) 0 (0.0) 0.002 Plastics, n (%) 10 (15.9) 2 (11.1) 7 (23.3) 1 (6.7) 0.29 Orthopedic spine, n (%) 2 (3.2) 1 (5.6) 1 (3.3) 0 (0.0) 0.67 *Intracranial head bleeds including subarachnoid hemorrhage, intraparenchymal hemorrhage, subdural hematoma, epidural hematoma, and intraventricular hemorrhage.
ISS, Injury Severity Score; TBI, traumatic brain injury.
- Table 3
Healthcare encounter cost
All injuries Orthopedic Facial Cranial P values Total hospital charges to insurance $86 376±$125 438 $97 562±$138 163 $65 408±$50 818 $122 136±$211 574 0.39 Total professional charges to insurance $9334±$14 711 $13 691±$21 773 $5784±$4015 $12 103±$18 577 0.17 Total billing for encounter $95 710±$138 215 $111 253±$158 031 $71 192±$54 027 $134 239±$228 501 0.37 - Table 4
Total billing associated with specific patient characteristics
Without variable With variable P value Patient demographics Male $83 932±$76 184 $101 146±$159 561 0.52 Age (years) <40 $74 472±$57 566 $116 215±$184 729 1.00 40–64 $110 436±$176 614 $76 861±$60 208 0.67 >64 $97 996±$141 640 $54 566±$23 888 0.34 Out-of-town visitor* $97 644±$140 365 $42 538±$486 0.27 Motor vehicle involvement $90 058±$123 940 $116 906±$187 586 0.09 Helmet use $97126±$140 459 $56 760±$35 898 0.59 Any intoxication† $69 558±$47 148 $110 965±$169 250 0.97 Positive BAL‡ $92 917±$128 932 $97 741±$146 536 0.83 Positive urine toxicology $92 724±$127 266 $108 198±$184 068 0.58 BIBA§ $116 214±$232 187 $88 304±$103 760 0.20 Clinical course Number of consultations 0–2 $224 165±$306 098 $71 625±$55 326 0.03 >2 $71 625±$55 326 $224 165±$306 098 0.03 Injuries ISS 0–5 $110 105±$157 562 $55 404±$36 708 0.01 6–9 $111 547±$177 735 $76 828±$64 825 0.78 10–14 $85 095±$106 651 $128 314±$209 823 0.05 >14 $84 091±$116 853 $415 245±$347 573 0.03 Concussion $70 494±$48 323 $116 859±$180 833 0.34 Intracranial bleed¶ $84 652±$44 214 $104 100±$15 626 0.04 TBI $80 629±$94 358 $510 434±$482 190 0.03 Extremity fracture $118 547±$213 981 $87 020±$113 898 0.72 Face fracture $121 666±$182 678 $64 763±$30 240 0.90 Results in text reported as difference between value in ‘With variable’ column as compared to ‘Without variable’ column. For example, male patients had an average total billing of $101 146 as compared to female patients with an average total billing of $83 932, amounting to an increased cost of $17 214 for male patients as compared to female patients.
*As reported by patient or clinical plan for follow-up visits.
†Intoxication defined as defined by clinical evaluation, positive BAL or urine toxicology.
‡BAL >11 mmol/L.
§Patient brought in by ambulance (BIBA).
¶Intracranial head bleeds including subarachnoid hemorrhage, intraparenchymal hemorrhage, subdural hematoma, epidural hematoma and intraventricular hemorrhage.
BAL, blood alcohol level; ISS, Injury Severity Score; TBI, traumatic brain injury.
- Table 5
Multivariable regression of total billing cost
Estimate 95% CI P value Patient demographics Male −$79 578 −$199 772–$40 615 0.18 Age (years) <40 Ref. 40–64 −$5385 −$89 424–$78 655 0.90 >64 $39 818 −$138 111–$217 747 0.65 Out-of-town visitor −$50 191 −$306 275–$205 893 0.69 Injury context Motor vehicle involvement $17 812 −$124 103–$159 728 0.80 Helmet use −$159 708 −$413 329–$93 913 0.21 Any intoxication* $231 377 $32 501–$430 254 0.02 Clinical course BIBA† −$10 475 −$111 059–$90 110 0.83 Number of consultations 0–1 Ref. >2 $200 339 $47 452–$353 226 0.01 Injuries ISS <6 Ref. 6–9 $2930 −$168 469–$174 329 0.97 10–14 $6862 −$202 951–$216 676 0.95 >14 $25 815 −$258 010–$309 640 0.85 Primary Injury Orthopedic Ref. Facial −$67 604 −$239 177–$103 969 0.42 Cranial $57 648 −$161 254–$276 550 0.59 Intracranial bleed‡ $ 75 528 $ 63 169 to $87 887 0.04 TBI $360 898 $116 228–$605 568 0.006 Extremity fracture −$60 896 −$225 661–$103 870 0.45 Face fracture $102 330 −$103 647–$308 308 0.31 *Intoxication defined as defined by clinical evaluation, positive BAL or urine toxicology.
†Patient brought in by ambulance (BIBA).
‡Intracranial head bleeds including subarachnoid hemorrhage, intraparenchymal hemorrhage, subdural hematoma, epidural hematoma and intraventricular hemorrhage.
ISS, Injury Severity Score; TBI, traumatic brain injury.
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Supplementary Data
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