The direct economic burden of blunt and penetrating trauma in a managed care population

J Trauma. 2007 Mar;62(3):622-9; discussion 629-30. doi: 10.1097/TA.0b013e318031afe3.

Abstract

Background: Although the prevalence of trauma in the United States is high, data on the economic burden of this public health problem to third-party payors is limited.

Methods: Retrospective claims from a large health plan were analyzed for 12,615 adults (age >or=18 years) hospitalized for blunt or penetrating trauma between January 1, 2003 and February 1, 2005. Per patient charges were estimated for resources utilized during a 6-month period before and after initial injury. Continuous health plan enrollment during these periods was required. Three cohorts were examined: isolated traumatic brain injury (TBI); other trauma with TBI (trauma w/TBI); and other trauma without TBI (trauma w/o TBI). Patients were also stratified by Injury Severity Score (ISS) and trauma designation of the admitting hospital.

Results: Initial hospitalization charges ranged from $32,627 for isolated TBI to $103,667 for trauma w/TBI. Charges for initial hospitalization were highest ($199,443) among patients with the most severe injuries. Overall, initial hospitalization charges were highest among those admitted to Level I trauma centers ($68,626); for trauma w/TBI, however, initial hospitalization charges were highest among those admitted to nontrauma centers ($130,997). Charges incurred during postdischarge medical encounters ranged from $16,361 for isolated TBI to $23,761 for trauma w/TBI. Increased charges for postdischarge encounters compared with the 6-month preinjury period ranged from $6,756 for isolated TBI to $19,771 for trauma w/TBI.

Conclusions: The economic burden of blunt and penetrating trauma to third-party payors is high. Efforts to reduce the incidence of trauma may result in substantial economic savings to managed care systems.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Ambulatory Care / economics
  • Brain Injuries / complications
  • Brain Injuries / economics
  • Brain Injuries / therapy
  • Drug Costs
  • Female
  • Health Expenditures*
  • Hospital Charges
  • Hospitalization / economics*
  • Humans
  • Injury Severity Score
  • Insurance, Health, Reimbursement / economics*
  • Male
  • Managed Care Programs / economics*
  • Middle Aged
  • Trauma Centers / economics
  • United States
  • Wounds, Nonpenetrating / economics*
  • Wounds, Nonpenetrating / therapy
  • Wounds, Penetrating / economics*
  • Wounds, Penetrating / therapy